Diphtheria: Symptoms, Causes and Treatment

Medically reviewed by Dr. Mandy Liedeman


Diphtheria is an infectious disease that mainly affects the throat and nose and can lead to shortness of breath, heart rhythm problems, and even death. While diphtheria is now rare in many parts of the world due to widespread vaccination, outbreaks can still occur, particularly in areas with low vaccination rates or during humanitarian crises. Hence, read this article to comprehensively understand diphtheria, including its symptoms, underlying causes, prevention methods, diagnosis procedures, and treatment options. 

What Is Diphtheria?

Diphtheria is a bacterial infection that occurs due to the bacterium Corynebacterium diphtheriae. It primarily affects the mucous membranes of the nose and throat but can also affect the skin. 

The disease is spread through respiratory droplets or contact with the skin injuries of an infectious person. Also, the general case fatality ratio for diphtheria is 5 to 10 percent, with increased death rates (up to 20%) among people younger than 5 and older than 40.

Causes of Diphtheria

Diphtheria occurs due to a bacterium known as Corynebacterium diphtheriae that spreads through airborne droplets or contact with the skin injuries of an infected person. The bacteria produce a toxin that can cause damage to the tissues in the throat, nose, and other parts of the body. The poison can also enter the bloodstream and cause damage to the heart, nerves, and other organs.

It is highly contagious and can spread quickly from one individual to another through coughing or sneezing. People not vaccinated against the disease are at a higher risk of infection. Moreover, the condition is more common in poor sanitation, overcrowded areas, and people with weakened immune systems.

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Symptoms of Diphtheria

The signs and symptoms of diphtheria usually begin 2 to 5 days after becoming infected. Signs and symptoms may include the following:

  • A thick, grey membrane covering the throat and tonsils
  • A sore throat and hoarseness
  • Swollen lymph nodes under the jaw
  • Difficulty breathing or rapid breathing
  • Nasal discharge
  • Fever and chills
  • Weakness or fatigue
  • Difficulty swallowing

However, in some people, infection with diphtheria-causing bacteria causes only a mild illness or no apparent signs and symptoms.

Diagnosis of Diphtheria

The diagnosis of diphtheria is usually based on a combination of clinical signs and laboratory tests. Diagnosing and treating diphtheria without any delay is essential to prevent serious complications. The healthcare provider will first perform a physical examination, looking for symptoms such as a sore throat, swollen glands, and a thick greyish-white membrane in the throat. The doctor may also ask about the patient’s vaccination history and recent travel to areas where diphtheria is more common.

Your healthcare provider may perform laboratory tests to confirm the diagnosis. These may include:

1. Culture of the bacteria: A patient’s throat or nose discharge sample is collected and sent to a laboratory for culture. If the bacteria are present, they will grow in the culture, which can confirm the diagnosis.

2. Polymerase chain reaction (PCR) testing: This test can detect the DNA of the bacteria in a patient’s sample, even if they are not growing in culture.

3. Blood tests: Blood tests can help detect the presence of the bacterial toxin and provide information about the severity of the infection.

Treatment Options for Diphtheria

Diphtheria treatment typically involves a combination of antibiotics and antitoxins.


Antibiotics, such as penicillin or erythromycin, can kill the bacteria that cause diphtheria. These medications are usually given intravenously (through a vein) in the hospital.


Antitoxin is a medication that can neutralize the toxin produced by diphtheria bacteria. It is preparation includes the blood of animals immunizing against the poison. Intravenous injections of antitoxin are preferable to treating diphtheria in the hospital.

In addition to these treatments, patients with diphtheria may need supportive care to manage symptoms and prevent complications. This may include:

Keeping the patient’s airway clear: 

Patients with severe diphtheria may need to be intubated (have a tube inserted into their airway) to help them breathe.

Managing fluids and electrolytes: 

Patients may need intravenous fluids to prevent dehydration and electrolyte replacement therapy to maintain the balance of essential minerals in their bodies.

Monitoring for complications: 

Patients with diphtheria may be at risk for heart problems or nerve damage. These complications are observable and manageable as needed.

It is essential to start diphtheria treatment immediately to prevent severe complications and reduce the risk of transmission to other people. In addition to treatment, vaccination is also an effective way to prevent diphtheria.

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Prevention of Diphtheria

Vaccination is the most effective way to prevent diphtheria.  The diphtheria vaccine is typically given as part of a combination vaccine called the DTaP vaccine, which also protects against tetanus and pertussis (whooping cough).

The vaccine is usually given to children in five doses, starting at two months of age and ending between 4-6 years of age. A booster dose is recommended for adults in adolescence, then every 10 years. In areas where diphtheria is more common, such as certain parts of Asia and Africa, it may be recommended that travelers receive a diphtheria vaccine before traveling. It is also essential to ensure that children receive all recommended vaccine doses to help prevent the spread of the disease.

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Other measures that can help prevent the spread of diphtheria include:

  • Avoiding close contact with sick people
  • Covering your mouth and nose while coughing or sneezing
  • Washing your hands frequently with soap and water for at least 20 seconds, especially after being in touch with someone who is sick
  • Cleaning and disinfecting surfaces with bacteria contamination.

Because of the pain and difficulties swallowing, you may need to supplement your nutrition with liquids and soft foods for a while. Furthermore, diphtheria recovery necessitates a lot of bed rest. Avoiding physical activity is especially crucial if your heart health is at risk. 

Booster Shot

Following the original round of immunizations you received as a child, you will require booster shots of the diphtheria vaccine to help you maintain your immune system. This is because diphtheria immunity decreases over time. Medical professionals administer a booster shot of this vaccine every 10 years to individuals aged 7 or older. Doctors may administer it as part of a three-shot series for those who have not previously received tetanus and diphtheria vaccines and are 7 years of age or older. The booster is administered as a Tdap vaccination or as a diphtheria booster in conjunction with a tetanus booster, the tetanus-diphtheria (Td) vaccine. This combination vaccine is administered by injection, typically into the arm or thigh.

Complications of Diphtheria

If diphtheria is left without treatment, it can direct to:

  • Breathing problems. Bacteria that cause diphtheria may produce a toxin that damages tissue in the immediate area of infection, usually the nose and throat. The disease creates a rugged, grey membrane of dead cells, bacteria and other substances at that site. This membrane can block and cause breathing problems.
  • Heart damage. The diphtheria poison may spread through the arteries and harm other body tissues. For example, diphtheria can damage the heart muscle, causing complications such as inflammation, soreness or tenderness of the heart muscle (myocarditis). Heart damage from myocarditis can be slight or severe. At its worst, myocarditis can result in heart failure and sudden death.
  • Nerve damage. Diphtheria can also cause severe damage to the nerves. Typical targets are nerves to the throat, where impaired nerve conduction can cause swallowing difficulties. Nerves in the arms and legs also may become swollen, causing muscle asthenia. If the diphtheria toxins damage the nerves that help control muscles used for breathing, these muscles may become paralyzed. At that point, you might need mechanical assistance to breathe.

Risk Factors of Diphtheria

Diphtheria is a bacterial infection that can be life-threatening, especially in unvaccinated individuals or those with weakened immune systems. Some of the risk factors for diphtheria include:

1. Not being vaccinated: Many countries have Diphtheria vaccination in routine childhood immunization schedules. Failure to receive the Diphtheria vaccine increases the risk of contracting the infection.

2. Close contact with infected individuals: Diphtheria spreads through close contact with infected people, surfaces, or objects contaminated with the bacteria.

3. Poor living conditions: Crowded living conditions, poor sanitation, and lack of access to healthcare increase the risk of diphtheria infection.

4. Compromised immune system: People with weakened immune systems, such as HIV/AIDS or undergoing chemotherapy, are more susceptible to diphtheria infection.

5. Age: Children under 5 and adults over 60 are at a greater risk of severe complications from diphtheria infection.

6. Travel to high-risk areas: Diphtheria is more common in most parts of the world, such as India, Pakistan, and parts of Africa, so traveling to these areas can increase the risk of infection.

Hence, following proper hygiene practices and staying up-to-date with vaccinations is essential to reducing the risk of diphtheria infection.

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When to Consult a Doctor?

Diphtheria is a severe bacterial infection that requires prompt medical attention. If you suspect you or someone you know may have diphtheria, you should consult a doctor immediately. Some signs and symptoms that may indicate a diphtheria infection include:

1. Sore throat: Diphtheria often begins with a sore throat that worsens over time.

2. Difficulty breathing or swallowing: Diphtheria can cause difficulty breathing or swallowing, which can be life-threatening.

3. Low-grade fever: A fever is common in diphtheria but may not be very high.

4. Swollen glands: The lymph nodes in the neck may become swollen and tender.

5. The greyish-white membrane in the throat: Diphtheria can cause a greyish-white membrane to form in the throat, which can obstruct the airway and cause breathing difficulties.

If you or someone you know experiences any of these symptoms, it is essential to seek medical care immediately. Diphtheria treatment is possible with antibiotics, antitoxin, and supportive care, but prompt treatment is necessary to prevent severe complications and reduce the risk of transmission to others.

Key Takeaways

In conclusion, diphtheria is a serious bacterial infection that can have severe complications and even be fatal. Vaccination is the best way to prevent the disease, and treatment involves antibiotics and antitoxins. While diphtheria is rare in developed countries, it still occurs in some parts of the world where vaccination rates are low. It is essential to be aware of diphtheria symptoms and seek medical attention if you suspect you may have the disease or have been exposed to someone who does.

FAQs about Diphtheria Answered by Your Doctors Online Team

What is diphtheria called today?

Over the period, it was called Microsporon diphtheritic, Bacillus diphtheria, membranous angina, and Mycobacterium diphtheria. The current terminology is Corynebacterium diphtheriae.

Is diphtheria very contagious?

Yes, it is a highly contagious and deadly bacterial disease that is spread through respiratory droplets or contaminated personal items.

Is diphtheria the same as whooping cough?

No, diphtheria and whooping cough (also known as pertussis) are not the same illness. Diphtheria is a contagious bacterial disease that occurs due to Corynebacterium diphtheriae, which can affect the respiratory system, skin, and other tissues. In comparison, whooping cough is a respiratory infection that the bacterium Bordetella pertussis causes. It shows symptoms like severe coughing fits that can make breathing difficult.

Is diphtheria an STD?

No, diphtheria is not a sexually transmitted disease (STD). It primarily spreads through respiratory droplets when infected individuals cough or sneeze, or touch objects contaminated with the bacteria.

Is diphtheria the same as tuberculosis?

No, diphtheria and tuberculosis are not the same diseases. They are caused by different bacteria and have different symptoms and treatment options.

Can you survive a slit throat?

Survival after a slit-throat injury depends on the extent of the injury and the promptness of medical care. If the injury is severe and involves significant blood vessels, it can be fatal within minutes. However, some people may survive slit-throat damage with prompt medical attention and appropriate treatment.

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