Common Pediatric Infections
Bull neck' in Diphtheria is due to - (AIIMS Nov 2014)
Clinical manifestations of diphtheria
a. Faucial (tonsillo pharyngeal) diphtheria
i. It is the commonest type of diphtherial infection.
ii. Incubation period is 2-5 days.
iii. Patients present with malaise, sore throat and moderate fever.
iv. A thick adherent pseudome tbrune (gray ot ythite) is present ofi one or both tonsils or adjacent pharynx
v. Dislodging the membrane is lihely to cause bleeding.
vi. A small percentage of patients present with massive swelling of the tonsils and uvula with cervical
vii. lymphadenopathy (bull neck) and severctoxemia ) Malignant diphtheiq-
viii. Systemic toxicity (toxemia) is usually most severe when pseudomembrane extends from tonsil and pharynx
(faucial diphtheria) to adjacent areas.
b. Leryngeal diphtheria
i. Presents as hoarseness and cough,
ii. It is the rflost severcforn. ofrespiratory diphtheio-
iii. Trucheostomy may be required.
c. Nasal diphtleria
i. Presents with unilateral or bilateral nasal discharge.
ii. Mildest form of respirstory diphtheria
d. Cutaneous diphtheria
i. Caused b1t nontoxigenic strains
ii. Presents as distinct "punched out" ulcers.
iii. More common in tropical areas.
iv. Other less common type of diphtheria are conjuctivrl, otitic, genital - (vulval, vaginal or prepucial), gastrointestitrd.