Diphtheria Overview and Symptoms

Respiratory diphtheria presents as a sore throat with low-grade fever and an adherent membrane of the tonsils, pharynx, or nose. Neck swelling is usually present in severe disease. Cutaneous diphtheria presents as infected skin lesions which lack a characteristic appearance.

Diptheria is relatively rare in the United States. Approximately 0.001 cases per 100,000 population in the U.S. since 1980; before the introduction of a vaccine in the 1920s incidence was 100-200 cases per 100,000 population.

Diphtheria remains endemic in developing countries. The countries of the former Soviet Union have reported >150,000 cases in an epidemic which began in 1990.

Myocarditis, polyneuritis, and airway obstruction are common complications of respiratory diphtheria; death occurs in 5%-10% of respiratory cases. Complications and deaths are much less frequent in cutaneous diphtheria.

Direct person-to-person transmission by intimate respiratory and physical contact. Cutaneous lesions are important in transmission.

Source: CDC

Alt: Diptheria