Diphtheria Symptoms

Quick Glance: Common Diphtheria Symptoms

Below is the list of common symptoms of diphtheria:

• A sore throat

• Mild fever and weakness

• Pain or difficulty while swallowing

• A thick grey or white coating in the nose or throat

• Swollen glands and soft tissues in the neck

• Hoarseness, a barking cough or noisy breathing

• Blood-stained or pus-like nasal discharge in nasal diphtheria

• A slow-healing skin ulcer in cutaneous diphtheria

Respiratory diphtheria usually develops gradually. It is characterised by a firmly attached pseudomembrane (a thick coating of damaged tissue) that can make swallowing or breathing difficult.

Diphtheria Symptoms That Should Not Be Ignored

Some diphtheria symptoms signal rapid disease progression or systemic toxin spread and must not be overlooked. A concise overview of these symptoms and what they may indicate is given in the table below:

Why Do Diphtheria Symptoms Occur?

Diphtheria is usually caused by toxin-producing strains of Corynebacterium diphtheriae. The bacteria attach to the mucous membranes (the moist tissues lining the nose, throat or voice box) and multiply at the site of infection.

The bacterial toxin stops nearby cells from making the proteins they need. As these cells die, they mix with bacteria, immune cells and fibrin (a protein involved in clotting) to form a thick pseudomembrane. This coating can make swallowing difficult and may partly or completely block the airway.

Additionally, the toxin can enter the bloodstream and reach other parts of the body. It may damage the myocardium (the heart muscle), peripheral nerves and, less commonly, the kidneys. These effects can cause abnormal heart rhythms, weakness, paralysis or reduced kidney function.

Diphtheria Symptoms That Require Immediate Medical Attention

The course of diphtheria is swift. Unlike other infectious conditions, diphtheria can quickly escalate from a simple sore throat to an emergency condition requiring immediate treatment due to the danger of the pseudomembrane spreading down the respiratory system and causing obstruction.

You must seek emergency treatment if you experience any of the following:

• Difficulty breathing or gasping

• Stridor (a high-pitched sound while breathing in)

• Bluish or grey lips, face or fingertips

• Rapidly increasing neck swelling

• Drooling or an inability to swallow

• Severe weakness, unusual drowsiness or collapse

• Chest pain, palpitations, fainting or an irregular heartbeat

• Double vision or new facial weakness

• Increasing difficulty in speaking or swallowing

• Weakness of the arms, legs or breathing muscles

• Very little urine with rapidly worsening illness

These symptoms may indicate airway obstruction, myocarditis, nerve damage or another severe complication and require urgent medical attention.

Symptoms of Diphtheria Based on Type

A concise overview of diphtheria based on its types is given in the table below, along with the associated symptoms:

Symptoms of Diphtheria in Children

Children generally develop the same symptoms as adults. However, airway swelling and obstruction may become serious more quickly, particularly in babies and young children.

Possible diphtheria symptoms in children include:

• Sore throat and mild fever

• Difficulty or pain while swallowing

• Poor feeding in babies

• Drooling

• A thick grey or white coating in the throat

• Swollen neck glands or marked neck swelling

• Hoarseness or a barking cough

• Noisy or difficult breathing

• Unusual tiredness, irritability or reduced responsiveness

• Bluish or grey lips in severe cases

A child with a grey throat membrane, increasing neck swelling, difficulty swallowing, or loud or noisy breathing requires immediate hospital assessment. Airway obstruction is more common in infants with respiratory diphtheria.

Can You Have Diphtheria Without Symptoms?

Yes. Some people infected with diphtheria-causing bacteria develop no symptoms or only mild throat symptoms. They may still carry the bacteria and pass them to others while the bacteria remain present.

People with some immunity may develop mild disease without the characteristic throat membrane. Cutaneous diphtheria may cause only a local skin ulcer without fever or other general symptoms.

If you have had close contact with a confirmed diphtheria case, you should receive prompt medical and public-health assessment, even if you feel well. Your vaccination status, need for testing, and preventive antibiotics may need to be reviewed.

When Can Diphtheria Symptoms Become Life-Threatening?

Diphtheria can become life-threatening if the pseudomembrane blocks the airway or if bacterial toxin damages the heart, nerves or kidneys.

Below are the conditions under which the symptoms of diphtheria become life-threatening and require urgent medical attention:

How are Diphtheria Symptoms Diagnosed?

Doctors often make a preliminary diagnosis from the symptoms and physical findings, particularly an adherent grey or white pseudomembrane. Samples should be collected for confirmation where possible.

The following is an overview of the tests required to diagnose diphtheria and their objectives: