Diphtheria is common in autumn and winter and spring, more than occurred in children under the age of 10 to 2 to 5 years of age the highest incidence. Since the liberation of China's emphasis on prevention, it is now rare in this disease.
Diphtheria incidence of the development process, mainly based on Corynebacterium diphtheriae infection occurred after the pathological changes in local lesion and systemic disease is divided into two broad categories.
(1) local lesions: diphtheria bacteria invades the human body outside the Organization to produce a toxin damages epithelial cells, necrosis, fibrin and leukocyte exudation. Cellulose solidified, forming a layer of pseudomembrane, diphtheria bacilli in the pseudomembrane reproduce the growth, resulting in more foreign-toxin, lesions caused by expansion of pseudomembranous spread to four weeks. Throat pseudomembrane attached to a more loose, and sometimes cough.
(2) systemic diseases: diphtheria toxin into the blood outside, there systemic poisoning, can cause toxic myocarditis, nephritis, peripheral neuropathy, or nerve damage.
ENT clinical manifestations of diphtheria as follows:
(1) Pharyngeal Diphtheria: Diphtheria of the most common for those who, according to speech disorders peaks Wu Ghosts? Types: ① limitations type: systemic symptoms may have fever, fatigue, discomfort. Minor local symptoms, mild sore throat. Appear on one or both tonsils white pseudomembrane, pseudomembrane may exceed the palatal arch, covering soft palate, uvula or posterior pharynx. Pseudomembranous difficult to erase, forced separation, there are bleeding wound surface. Pseudomembranous bacterial smear or culture, can Richard diphtheria bacilli. ② poisoning type: onset more acute pseudomembranous rapid expansion of the systemic symptoms of poisoning appear rapidly. If the merging streptococcal infection, often fever, local tonsils, uvula, soft palate and other organizations and severe swelling; cervical lymph nodes, even the neck thicker, such as "bull neck."
(2) throat Diphtheria: Diphtheria hose down the spread of multi-diphtheria caused by the pharynx, but there were primary in the larynx. Invasive lesions larynx, the multi-cough and hoarseness. When the laryngeal mucosa swelling or pseudomembranous supraglottic obstruction, it can cause breathing difficulties and throat inspiratory stridor. The sustainable development of disease appeared three concave sign, if not promptly lift the block, will died of suffocation. Laryngeal mucosa can sometimes extends the tracheobronchial down, can cause lower respiratory tract obstruction.
(3) Nasal Diphtheria: rare. Is divided into primary and secondary categories, the former for the diphtheria bacilli in the nasal cavity and the incidence of direct invasion, systemic poisoning, minor; the latter by the spread of diphtheria from the pharynx, systemic symptoms and poisoning are heavier. Basically the same symptoms and general rhinitis, nasal congestion, runny nose, but frequently bloody nose. Examination showed nasal vestibule and the upper lip skin flushing, erosion, nasal mucosal surface covered with gray and white pseudomembrane, especially common in the nasal septum, the removal of pseudomembrane often left bleeding ulcer.
(4) ear Diphtheria: Diphtheria rare middle ear. Secondary to nasal, pharyngeal diphtheria, diphtheria bacilli into the tympanum through the Eustachian tube, or through the tympanic membrane into the attic. Similar symptoms and generalized purulent otitis media, severe earache, eardrum perforation, the outflow of blood and pus-like discharge dirty pseudomembrane, with the smell.