Summary: There are two types of clinical diphtheria nasopharyngeal and cutaneous Symptoms of pharyngeal diphtheria vary from mild pharyngitis to hypoxia due to airway obstruction by the pseudomembrane Fig 32 1 The involvement of cervical lymph nodes may cause profound swelling of the neck bull neck diphtheria and the patient may have a fever 103 �F The skin lesions in cutaneous diphtheria are usually covered by a gray brown pseudomembrane Life threatening systemic complications principally loss of motor function e g difficulty in swallowing and congestive heart failure may develop as a result of the action of diphtheria toxin on peripheral motor neurons and the myocardium Figure 32 1 Clinical Manifestations Pathogenesis of diphtheria Structure Classification and Antigenic Types
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