Diagnosis

Doctors may suspect diphtheria in a sick child who has a sore throat with a gray membrane covering the tonsils and throat. Growth of C. diphtheriae in a laboratory culture of material from the throat membrane pins down the diagnosis. Your doctor should notify the laboratory that diphtheria is suspected, because special media are needed for the growth of C. diphtheriae cultures.

Doctors can also take a sample of tissue from an infected wound and have it tested in a laboratory to check for the type of diphtheria that affects the skin (cutaneous diphtheria).

If a doctor suspects diphtheria, treatment begins immediately, even before the results of bacterial tests are available.

Treatment

Diphtheria is a serious illness. Doctors treat it immediately and aggressively with these medications:

  • An antitoxin. If doctors suspect diphtheria, the infected child or adult receives an antitoxin. The antitoxin, injected into a vein or muscle, neutralizes the diphtheria toxin already circulating in the body.

    Before giving an antitoxin, doctors may perform skin allergy tests to make sure that the infected person doesn't have an allergy to the antitoxin. People who are allergic must first be desensitized to the antitoxin. Doctors accomplish this by initially giving small doses of the antitoxin and then gradually increasing the dosage.

  • Antibiotics. Diphtheria is also treated with antibiotics, such as penicillin or erythromycin. Antibiotics help kill bacteria in the body, clearing up infections. Antibiotics reduce to just a few days the length of time that a person with diphtheria is contagious.

Children and adults who have diphtheria often need to be in the hospital for treatment. They may be isolated in an intensive care unit because diphtheria can spread easily to anyone not immunized against the disease.

Doctors may remove some of the thick, gray covering in the throat if the covering is obstructing breathing.

Preventive treatments

If you've been exposed to a person infected with diphtheria, see a doctor for testing and possible treatment. Your doctor may give you a prescription for antibiotics to help prevent you from developing the disease. You may also need a booster dose of the diphtheria vaccine.

Doctors treat people who are found to be carriers of diphtheria with antibiotics to clear their systems of the bacteria, as well.

Lifestyle and home remedies

Recovering from diphtheria requires lots of bed rest. Avoiding any physical exertion is particularly important if your heart has been affected. You may need to stay in bed for a few weeks or until you make a full recovery.

Strict isolation while you're contagious also is important to prevent spread of the infection. Careful hand-washing by everyone in your house helps prevent spread of the infection. Because of pain and difficulty swallowing, you may need to get your nutrition through liquids and soft foods for a while.

Once you recover from diphtheria, you'll need a full course of diphtheria vaccine to prevent a recurrence. Having diphtheria doesn't guarantee you lifetime immunity. You can get diphtheria more than once if you're not fully immunized against it.

Preparing for your appointment

If you have symptoms of diphtheria or have come into contact with someone who has diphtheria, call your doctor right away. Depending on the severity of your symptoms and on your vaccination history, you may be told to go to the emergency room or call 911 or your local emergency number for medical help.

If your doctor determines that he or she should see you first, it's critical to be well-prepared for your appointment. Here's some information to help you get ready and know what to expect from your doctor.

Information to gather in advance

  • Pre-appointment restrictions. At the time you make your appointment, ask if there are any restrictions you need to follow in the time leading up to your visit, including whether you should be isolated to avoid spreading infection.
  • Office visit instructions. Ask your doctor whether you should be isolated when you come to the office for your appointment.
  • Symptom history. Write down any symptoms you've been experiencing, and for how long.
  • Recent exposure to possible sources of infection. Your doctor will be especially interested to know if you have recently traveled abroad and where.
  • Vaccination record. Find out before your appointment whether your vaccinations are up to date. Bring a copy of your immunization record, if possible.
  • Medical history. Make a list of your key medical information, including other conditions for which you're being treated and any medications, vitamins or supplements you're currently taking.
  • Questions to ask your doctor. Write down your questions in advance so that you can make the most of your time with your doctor.

The list below suggests questions to raise with your doctor about diphtheria. Don't hesitate to ask more questions during your appointment.

  • Could I have diphtheria?
  • Are there any other possible causes for my symptoms?
  • What kinds of tests do I need?
  • What treatment approach do you recommend?
  • Are there any possible side effects from the medications I'll be taking?
  • How long do you expect a full recovery to take?
  • When do you expect I will be able to resume normal activities?
  • Am I at risk of any long-term complications from diphtheria?
  • Am I contagious? How can I reduce my risk of passing my illness to others?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

  • When did you first begin experiencing symptoms?
  • Have you had any trouble breathing, a sore throat or difficulty swallowing?
  • Have you had a fever? How high was the fever at its peak, and how long did it last?
  • Have you recently been exposed to anyone with diphtheria?
  • Is anyone close to you having similar symptoms?
  • Have you recently traveled abroad? Where?
  • Did you update your immunizations before traveling?
  • Are all of your immunizations current?
  • Are you being treated for any other medical conditions?
Dec. 08, 2016
References
  1. Ferri FF. Diphtheria. In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Sept. 23, 2016.
  2. Barroso LF, et al. Epidemiology, pathophysiology of diphtheria. http://www.uptodate.com/home. Accessed Sept. 23, 2016.
  3. Barroso LF, et al. Clinical manifestations, diagnosis, and treatment of diphtheria. http://www.uptodate.com/home. Accessed Sept. 23, 2016.
  4. Diptheria. Merck Manual Professional Version. https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria. Accessed Sept. 23, 2016.
  5. Birth-18 years and catch-up immunization schedules. Centers for Disease Control and Prevention http://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html. Accessed Sept. 23, 2016.
  6. Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years and older — United States, 2016. Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/volumes/65/wr/mm6504a5.htm. Accessed Sept. 23, 2016.
  7. Tdap (Tetanus, diphtheria, pertussis) vaccine information statement. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.html. Accessed Sept. 23, 2016.