diphtheria

(dĭfthēr`ēə), acute contagious disease caused by Corynebacterium diphtheriae (Klebs-Loffler bacillus) bacteria that have been infected by a bacteriophage. It begins as a soreness of the throat with fever. The bacteria lodge in the mucous membranes of the throat, producing virulent toxinstoxin,
poison produced by living organisms. Toxins are classified as either exotoxins or endotoxins. Exotoxins are a diverse group of soluble proteins released into the surrounding tissue by living bacterial cells. Exotoxins have specific reaction sites in the host; e.g.
..... Click the link for more information. that destroy the tissue. The resultant formation of a tough gray membrane is one of the most dangerous aspects of diphtheria, since it can spread to the larynxlarynx
, organ of voice in mammals. Commonly known as the voice box, the larynx is a tubular chamber about 2 in. (5 cm) high, consisting of walls of cartilage bound by ligaments and membranes, and moved by muscles. The human larynx extends from the trachea, or windpipe.
..... Click the link for more information. and cause suffocation. Deaths from diphtheria often result from inflammation of the heart. Diphtheria usually occurs in children of preschool age. Treatment with antitoxinantitoxin,
any of a group of antibodies formed in the body as a response to the introduction of poisonous products, or toxins. By introducing small amounts of a specific toxin into the healthy body, it is possible to stimulate the production of antitoxin so that the body's
..... Click the link for more information. is begun as early as possible. Penicillinpenicillin,
any of a group of chemically similar substances obtained from molds of the genus Penicillium that were the first antibiotic agents to be used successfully in the treatment of bacterial infections in humans.
..... Click the link for more information. or erythromycinerythromycin
, any of several related antibiotic drugs produced by bacteria of the genus Streptomyces (see antibiotic). Erythromycin is most effective against gram-positive bacteria such as pneumococci, streptococci, and some staphylococci (see Gram's stain).
..... Click the link for more information. is also given, particularly to guard against complicating factors such as pneumoniapneumonia
, acute infection of one or both lungs that can be caused by a bacterium, usually Streptococcus pneumoniae (also called pneumococcus; see streptococcus), or by a virus, fungus, or other organism.
..... Click the link for more information. or streptococcal infection. Diphtheria was once a common and dreaded disease with a high mortality rate; it is now rare in countries where infants are vaccinated (see vaccinationvaccination,
means of producing immunity against pathogens, such as viruses and bacteria, by the introduction of live, killed, or altered antigens that stimulate the body to produce antibodies against more dangerous forms.
..... Click the link for more information. ). Underimmunization, however, can lead to epidemicsepidemic,
outbreak of disease that affects a much greater number of people than is usual for the locality or that spreads to regions where it is ordinarily not present. A disease that tends to be restricted to a particular region (endemic disease) can become epidemic if
..... Click the link for more information. such as the one in Russia during 1994–95.

Diphtheria

An acute infectious disease of humans caused by Corynebacterium diphtheriae. Classically, the disease is characterized by low-grade fever, sore throat, and a pseudomembrane covering the tonsils and pharynx. Complications such as inflammation of the heart, paralysis, and even death may occur due to exotoxins elaborated by toxigenic strains of the bacteria. The upper respiratory tract is the most common portal of entry for C. diphtheriae. It can also invade the skin and, more rarely, the genitalia, eye, or middle ear. The disease has an insidious onset after a usual incubation period of 2–5 days.

The only specific therapy is diphtheria antitoxin, administered in doses proportional to the severity of the disease. Antitoxin is produced by hyperimmunizing horses with diphtheria toxoid and toxin. It is effective only if administered prior to the binding of circulating toxin to target cells. Antibiotics do not alter the course, the incidence of complications, or the outcome of diphtheria, but are used to eliminate the organism from the patient.

Persons with protective antitoxin titers may become infected with diphtheria but do not develop severe disease. Since the 1920s, active immunization with diphtheria toxoid has proved safe and effective in preventing diphtheria in many countries. Diphtheria toxoid is produced by incubating the toxin with formalin. Active immunization requires a primary series of four doses, usually at 2, 4, 6, and 18 months of age, followed by a booster at school entry. See Immunity, Medical bacteriology, Toxin, Vaccination

Diphtheria

an acute infectious disease characterized by inflammation, the formation of a tough membrane at the point of introduction of the causative agent of the disease, and a severe general poisoning (intoxication) of the organism.

The causative agent of diphtheria (Corynebacterium diphtheriae) was discovered by the German bacteriologist E. Klebs in 1883 and was isolated in a pure culture by the German bacteriologist F. Löffler. The pathogen is rod-shaped and produces diphtheria exotoxin. The source of infection in diphtheria is a sick person or carrier (a healthy person or a person who has recovered from diphtheria). The diphtheria bacilli are released into the environment with drops of mucus in talking, sneezing, or coughing. Infection occurs when the microbe enters the organism through the mucous membranes of the pharynx, nose, and upper respiratory tracts, and more rarely, through the conjunctiva of the eyes, broken skin, and so forth (the airborne droplet path). The pathogen may also enter through the mouth with food and through various articles such as underwear, clothing, books, and toys. The diphtheria bacillus, having reached the mucous membranes (or the skin), secretes a toxin that causes necrosis (dying) of the epithelium and affection of the blood vessels, with the deposition of a network of fibrin (blood protein) and the formation of a membrane. A general intoxication develops when the toxin reaches the blood. The intoxication predominantly affects the nervous and cardiovascular systems, the adrenals, and kidneys. The incubation period is two to ten days.

In terms of the localization of the process, a distinction is made between diphtheria of the pharynx (the most frequent form), respiratory tract, nose, eyes, ears, external sex organs (in young girls), skin, the umbilicus in the newborn, of wounds, and so forth.

In the localized form of pharyngeal diphtheria the membranes cover the tonsils without extending beyond them, the lymph nodes are moderately enlarged, and the body temperature rises to 38.5°-39° C. Malaise, loss of appetite, and headaches are mildly manifested. In the diffuse form of pharyngeal diphtheria the membranes spread from the tonsils to the mucous membranes of the palatine arches, uvula, and pharynx; general malaise is rather clearly manifested. The toxic form of pharyngeal diphtheria is characterized by a broad lesion of the pharynx; the tonsils are edematous, and their surface is covered by thick membranes of a dirty white color. The process can extend to the nasopharynx and the nasal cavity. Usually, edema of the subcutaneous tissue develops around the enlarged superior cervical lymph nodes. The phenomena of intoxication progressively increase: the heart rhythm is disrupted, swallowing is difficult, and when the process spreads to the respiratory organs, breathing is disrupted. Moreover, during the phenomena of myocarditis in the acute period, nosebleeds are observed. There are stomach pains and diarrhea, and a collapse may occur.

In diphtheria of the respiratory tract, with localization of the process on the mucous membrane of the larynx or the trachea, as a consequence of the formation of membranes, edema, infiltration of the mucous membrane, and spasms of the larynx musculature, respiratory disturbances grow; this is known as diphtheritic croup. The croup is manifested by a “barking” cough, a hoarse voice, even complete aphonia (loss of voice), and acute difficulty in inhaling. With the spread of the process to the bronchi, the severe form of diphtheria, diffuse croup, occurs.

Nasal diphtheria is encountered in young children, and intoxication is not usually observed. Nasal diphtheria is manifested by a unilateral cold with bloody secretions and tends to have an extended course.

Diphtheria of the eyes, ears, external sex organs, digestive tract, skin, and wounds, including the umbilical wound in the newborn, is almost not encountered in modern medical practice.

Complications are noted basically only with the toxic form of diphtheria, particularly if the start of serotherapy is delayed. Collapse develops on the second, third, or fourth day of the illness, and severe myocarditis on the fifth or sixth day. Sometimes peripheral paralyses, paralyses of the cranial nerves, and toxic nephrosis develop; with diphtheritic croup pneumonia develops.

Treatment includes the earliest possible administration of antitoxic antidiphtheric serum, vitamin therapy, and antibacterial therapy. In diphtheritic croup, when there is an increase in the phenomena of disruption of breathing and anoxia, an emergency operation (intubation or tracheotomy) should be performed.

Active immunization plays the basic role in combating diphtheria. In the USSR antidiphtheric inoculations are obligatory for all children. (In the period from the age of five or six months up to 12 years one vaccination and three revaccinations are administered.) Immunization is achieved by adsorbed diphtheria toxoid. Since 1958, in the USSR, inoculations have been administered with the associated preparation (AKDS) which, in addition to the diphtheria toxoid, includes whooping cough vaccine and tetanus toxoid. Due to the active immunization program, the diphtheria morbidity rate in the USSR has declined sharply (by 30.7 times from 1959 through 1966).

Other preventive measures consist in discovering and isolating (hospitalizing) sick persons as quickly as possible. After hospitalization of the sick person, the quarters are disinfected. All persons who have been in contact with the patient are given repeated bacteriological examinations and medical supervision for seven days. Children who have been in contact with sick persons are not allowed to attend children’s institutions (creches, nurseries, schools, and so forth) during this period. The state of children’s specific immunity is checked using the Schick test (named after the Austrian physician B. Schick).

REFERENCES

Molchanov, V. I. Difteriia, 2nd ed. Moscow, 1960.
Titova, A. I., and S. Ia. Flekser. Difteriia. Moscow, 1967.

R. N. RYLEEVA and M. IA. STUDENIKIN

diphtheria

[dif′thir·ē·ə] (medicine) A communicable bacterial disease of humans caused by the growth of Corynebacterium diphtheriae on any mucous membrane, especially of the throat.

diphtheria

an acute contagious disease caused by the bacillus Corynebacterium diphtheriae, producing fever, severe prostration, and difficulty in breathing and swallowing as the result of swelling of the throat and formation of a false membrane

diphtheria

Diphtheria

Definition

Diphtheria is a potentially fatal, contagious disease that usually involves the nose, throat, and air passages, but may also infect the skin. Its most striking feature is the formation of a grayish membrane covering the tonsils and upper part of the throat.

Description

Like many other upper respiratory diseases, diphtheria is most likely to break out during the winter months. At one time it was a major childhood killer, but it is now rare in developed countries because of widespread immunization. Since 1988, all confirmed cases in the United States have involved visitors or immigrants. In countries that do not have routine immunization against this infection, the mortality rate varies from 1.5-25%.Persons who have not been immunized may get diphtheria at any age. The disease is spread most often by droplets from the coughing or sneezing of an infected person or carrier. The incubation period is two to seven days, with an average of three days. It is vital to seek medical help at once when diphtheria is suspected, because treatment requires emergency measures for adults as well as children.

Causes and symptoms

The symptoms of diphtheria are caused by toxins produced by the diphtheria bacillus, Corynebacterium diphtheriae (from the Greek for "rubber membrane"). In fact, toxin production is related to infections of the bacillus itself with a particular bacteria virus called a phage (from bacteriophage; a virus that infects bacteria). The intoxication destroys healthy tissue in the upper area of the throat around the tonsils, or in open wounds in the skin. Fluid from the dying cells then coagulates to form the telltale gray or grayish green membrane. Inside the membrane, the bacteria produce an exotoxin, which is a poisonous secretion that causes the life-threatening symptoms of diphtheria. The exotoxin is carried throughout the body in the bloodstream, destroying healthy tissue in other parts of the body.The most serious complications caused by the exotoxin are inflammations of the heart muscle (myocarditis) and damage to the nervous system. The risk of serious complications is increased as the time between onset of symptoms and the administration of antitoxin increases, and as the size of the membrane formed increases. The myocarditis may cause disturbances in the heart rhythm and may culminate in heart failure. The symptoms of nervous system involvement can include seeing double (diplopia), painful or difficult swallowing, and slurred speech or loss of voice, which are all indications of the exotoxin's effect on nerve functions. The exotoxin may also cause severe swelling in the neck ("bull neck").The signs and symptoms of diphtheria vary according to the location of the infection:

Nasal

Nasal diphtheria produces few symptoms other than a watery or bloody discharge. On examination, there may be a small visible membrane in the nasal passages. Nasal infection rarely causes complications by itself, but it is a public health problem because it spreads the disease more rapidly than other forms of diphtheria.

Pharyngeal

Pharyngeal diphtheria gets its name from the pharynx, which is the part of the upper throat that connects the mouth and nasal passages with the voice box. This is the most common form of diphtheria, causing the characteristic throat membrane. The membrane often bleeds if it is scraped or cut. It is important not to try to remove the membrane because the trauma may increase the body's absorption of the exotoxin. Other signs and symptoms of pharyngeal diphtheria include mild sore throat, fever of 101-102°F (38.3-38.9°C), a rapid pulse, and general body weakness.

Laryngeal

Laryngeal diphtheria, which involves the voice box or larynx, is the form most likely to produce serious complications. The fever is usually higher in this form of diphtheria (103-104°F or 39.4-40°C) and the patient is very weak. Patients may have a severe cough, have difficulty breathing, or lose their voice completely. The development of a "bull neck" indicates a high level of exotoxin in the bloodstream. Obstruction of the airway may result in respiratory compromise and death.

Skin

This form of diphtheria, which is sometimes called cutaneous diphtheria, accounts for about 33% of diphtheria cases. It is found chiefly among people with poor hygiene. Any break in the skin can become infected with diphtheria. The infected tissue develops an ulcerated area and a diphtheria membrane may form over the wound but is not always present. The wound or ulcer is slow to heal and may be numb or insensitive when touched.

Diagnosis

Because diphtheria must be treated as quickly as possible, doctors usually make the diagnosis on the basis of the visible symptoms without waiting for test results.In making the diagnosis, the doctor examines the patient's eyes, ears, nose, and throat in order to rule out other diseases that may cause fever and sore throat, such as infectious mononucleosis, a sinus infection, or strep throat. The most important single symptom that suggests diphtheria is the membrane. When a patient develops skin infections during an outbreak of diphtheria, the doctor will consider the possibility of cutaneous diphtheria and take a smear to confirm the diagnosis.

Laboratory tests

The diagnosis of diphtheria can be confirmed by the results of a culture obtained from the infected area. Material from the swab is put on a microscope slide and stained using a procedure called Gram's stain. The diphtheria bacillus is called Gram-positive because it holds the dye after the slide is rinsed with alcohol. Under the microscope, diphtheria bacilli look like beaded rod-shaped cells, grouped in patterns that resemble Chinese characters. Another laboratory test involves growing the diphtheria bacillus on a special material called Loeffler's medium.

Treatment

Diphtheria is a serious disease requiring hospital treatment in an intensive care unit if the patient has developed respiratory symptoms. Treatment includes a combination of medications and supportive care:

Antitoxin

The most important step is prompt administration of diphtheria antitoxin, without waiting for laboratory results. The antitoxin is made from horse serum and works by neutralizing any circulating exotoxin. The doctor must first test the patient for sensitivity to animal serum. Patients who are sensitive (about 10%) must be desensitized with diluted antitoxin, since the antitoxin is the only specific substance that will counteract diphtheria exotoxin. No human antitoxin is available for the treatment of diphtheria.The dose ranges from 20,000-100,000 units, depending on the severity and length of time of symptoms occurring before treatment. Diphtheria antitoxin is usually given intravenously.

Antibiotics

Antibiotics are given to wipe out the bacteria, to prevent the spread of the disease, and to protect the patient from developing pneumonia. They are not a substitute for treatment with antitoxin. Both adults and children may be given penicillin, ampicillin, or erythromycin. Erythromycin appears to be more effective than penicillin in treating people who are carriers because of better penetration into the infected area.Cutaneous diphtheria is usually treated by cleansing the wound thoroughly with soap and water, and giving the patient antibiotics for 10 days.

Supportive care

Diphtheria patients need bed rest with intensive nursing care, including extra fluids, oxygenation, and monitoring for possible heart problems, airway blockage, or involvement of the nervous system. Patients with laryngeal diphtheria are kept in a croup tent or high-humidity environment; they may also need throat suctioning or emergency surgery if their airway is blocked.Patients recovering from diphtheria should rest at home for a minimum of two to three weeks, especially if they have heart complications. In addition, patients should be immunized against diphtheria after recovery, because having the disease does not always induce antitoxin formation and protect them from reinfection.

Prevention of complications

Diphtheria patients who develop myocarditis may be treated with oxygen and with medications to prevent irregular heart rhythms. An artificial pacemaker may be needed. Patients with difficulty swallowing can be fed through a tube inserted into the stomach through the nose. Patients who cannot breathe are usually put on mechanical respirators.

Prognosis

The prognosis depends on the size and location of the membrane and on early treatment with antitoxin; the longer the delay, the higher the death rate. The most vulnerable patients are children under age 15 and those who develop pneumonia or myocarditis. Nasal and cutaneous diphtheria are rarely fatal.

Prevention

Prevention of diphtheria has four aspects:

Immunization

Universal immunization is the most effective means of preventing diphtheria. The standard course of immunization for healthy children is three doses of DPT (diphtheria-tetanus-pertussis) preparation given between two months and six months of age, with booster doses given at 18 months and at entry into school. Adults should be immunized at 10 year intervals with Td (tetanus-diphtheria) toxoid. A toxoid is a bacterial toxin that is treated to make it harmless but still can induce immunity to the disease.

Isolation of patients

Diphtheria patients must be isolated for one to seven days or until two successive cultures show that they are no longer contagious. Children placed in isolation are usually assigned a primary nurse for emotional support.

Identification and treatment of contacts

Because diphtheria is highly contagious and has a short incubation period, family members and other contacts of diphtheria patients must be watched for symptoms and tested to see if they are carriers. They are usually given antibiotics for seven days and a booster shot of diphtheria/tetanus toxoid.

Reporting cases to public health authorities

Reporting is necessary to track potential epidemics, to help doctors identify the specific strain of diphtheria, and to see if resistance to penicillin or erythromycin has developed.

Resources

Books

Chambers, Henry F. "Infectious Diseases: Bacterial & Chlamydial." In Current Medical Diagnosis and Treatment, 1998, edited by Stephen McPhee, et al., 37th ed. Stamford: Appleton & Lange, 1997.

Key terms

Antitoxin — An antibody against an exotoxin, usually derived from horse serum.Bacillus — A rod-shaped bacterium, such as the diphtheria bacterium.Carrier — A person who may harbor an organism without symptoms and may transmit it to others.Cutaneous — Located in the skin.Diphtheria-tetanus-pertussis (DTP) — The standard preparation used to immunize children against diphtheria, tetanus, and whooping cough. A so-called "acellular pertussis" vaccine (aP) is usually used since its release in the mid-1990s.Exotoxin — A poisonous secretion produced by bacilli which is carried in the bloodstream to other parts of the body.Gram's stain — A dye staining technique used in laboratory tests to determine the presence and type of bacteria.Loeffler's medium — A special substance used to grow diphtheria bacilli to confirm the diagnosis.Myocarditis — Inflammation of the heart tissue.Toxoid — A preparation made from inactivated exotoxin, used in immunization.

diphtheria

[dif-thēr´e-ah] an acute, highly contagious childhood disease that generally affects the membranes of the throat and, less frequently, the nose; in rare instances it can affect other parts of the body, notably the skin, following an open wound. Caused by the bacillus Corynebacterium diphtheriae, it can be fatal if not treated promptly. However, repeated exposure to the causative organisms may provide a natural immunity. adj., adj diphthe´rial, diphther´ic, diphtherit´ic.
Diphtheria spreads in droplets of moisture from the mouth, nose, or throat of an infected person. It may also be spread by handkerchiefs, towels, eating utensils, or any other object used by an infected person or sprayed by his coughing or sneezing. It may also be transmitted by a healthy person who is nevertheless a carrier of the disease or by someone who is convalescing from diphtheria. The incubation period of the disease is generally between 2 and 5 days, sometimes longer. An infected person may continue to have the bacilli in his throat from 2 to 4 weeks after he has recovered from its effects. Symptoms. The first symptoms of diphtheria usually include sore throat, fever, headache, and nausea. Patches of grayish or dirty-yellowish membrane form in the throat, and gradually grow into one membrane. This membrane, combined with swelling of the throat, may interfere with swallowing or breathing. In severe cases, when other measures fail, a tracheostomy may be necessary to restore breathing.
The diphtheria bacillus also produces a toxin that spreads throughout the body and may damage the heart and nerves permanently. Diagnosis of the disease can be verified by identifying the causative organisms from throat cultures. Susceptibility to diphtheria is determined by the Schick test. A positive skin test indicates the absence of circulating antibodies to the diphtheria toxin, but a pseudoreaction can also occur. Treatment. Diphtheria antitoxin is administered to counteract the toxic reaction from the bacillus. Prognosis depends on the severity of the infection and especially on how soon the antitoxin is given. Rest, antibiotics, and general hygienic measures are used to combat the infection. Oxygen is administered as necessary to relieve dyspnea and cyanosis. Cardiac complications are usually more severe in adults; thus the convalescent period is extended for these patients.Prevention. Immunization should be begun between the sixth and eighth weeks of an infant's life. vaccine" >Diphtheria and tetanus toxoids and pertussis vaccine (DTaP) is the preferred vaccine for all doses in the vaccination series. Booster doses are also needed later in life. (See also table under immunization.)
Once one of the most fatal diseases of childhood, cases of diphtheria and death from the disease have become almost nonexistent in countries where mass immunization has been practiced.

diph·the·ri·a

(dif-thēr'ē-ă), Avoid the misspelling/mispronunciation dipheria.A specific infectious disease due to the bacterium Corynebacterium diphtheriae and its highly potent toxin; marked by severe inflammation that can form a membranous coating, with formation of a thick fibrinous exudate, of the mucous membrane of the pharynx, the nose, and sometimes the tracheobronchial tree; the toxin produces degeneration in peripheral nerves, heart muscle, and other tissues, diphtheria had a high fatality rate, especially in children, but is now rare because of an effective vaccine. [G. diphthera, leather]

diphtheria

(dĭf-thîr′ē-ə, dĭp-)n. An acute infectious disease caused by the bacterium Corynebacterium diphtheriae, which infects mucous membranes of the throat, causing formation of a thick layer called the false membrane that can obstruct breathing, and producing a potent toxin that enters the bloodstream and causes systemic effects that include damage to the heart and nervous system.

diph′the·rit′ic (-thə-rĭt′ĭk), diph·ther′ic (-thĕr′ĭk), diph·the′ri·al adj.

diphtheria

Diphtheritis Infectious disease An acute, potentially fatal infection, primarily of the upper respiratory tract, throat. See DTP–Diphtheria-Tetanus-Pertussis and DTaP–acellular Pertussis vaccines.

diph·the·ri·a

(dif-thēr'ē-ă) A specific infectious disease due to Corynebacterium diphtheriae and its highly potent toxin; marked by severe inflammation with formation of a thick membranous coating of the pharynx, the nose, and sometimes the tracheobronchial tree; the toxin produces degeneration in peripheral nerves, heart muscle, and other tissues. Symptoms include fever, fatigue, sore throat, difficulty in swallowing, and nausea. Adult morbidity ranges from 5-10%; in children younger than 5 years of age, mortality approaches 20%. [G. diphthera, leather]

diphtheria

A serious, and highly infectious, disease caused by the toxin of an organism Corynebacterium diphtheriae . This normally attacks the throat causing a membrane-like exudate of clotted serum, white cells, bacteria and dead surface tissue cells to form. This may obstruct the upper air passages, necessitating an emergency artificial opening into the windpipe (a tracheostomy) to save life. The bacterial toxin can also affect the heart.

diphtheria

a serious disease of the upper respiratory tract in man caused by toxins produced by the bacterium Corynebacterium diphtheriae. The toxins cause NECROSIS of epithelial cells in the throat, resulting in the production of a greyish EXUDATE that gradually forms a membrane on the tonsils and can spread upwards into the nasal passages, or downwards into the larynx causing suffocation if not treated.

diph·the·ri·a

(dif-thēr'ē-ă) Avoid the misspelling/mispronunciation dipheria.A specific infectious disease due to infection by the bacterium Corynebacterium diphtheriae and its highly potent toxin. [G. diphthera, leather]

Patient discussion about diphtheria

Q. I need to know anything there is to know about Diphtheria, where can I find information? I have a paper that’s due to this Monday and I need to know where it comes from, what it is, and so on. If you could help me find a site that covers all i need to know that would be great.A.
http://www.mayoclinic.com/health/diphtheria/DS00495
Here's everything you could possibly need to know about it, including:
* Introduction
* Signs and symptoms
* Causes
* Risk factors
* When to seek medical advice
* Screening and diagnosis
* Complications
* Treatment
* Prevention
* Self-care

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REFERENCES

diphtheria

diphtheria

diphtheria

Diphtheria

Definition

Description

Causes and symptoms

Nasal

Pharyngeal

Laryngeal

Skin

Diagnosis

Laboratory tests

Treatment

Antitoxin

Antibiotics

Supportive care

Prevention of complications

Prognosis

Prevention

Immunization

Isolation of patients

Identification and treatment of contacts

Reporting cases to public health authorities

Resources

Books

Key terms

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diphtheria

diph·the·ri·a

diphtheria

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Words related to diphtheria

noun acute contagious infection caused by the bacterium Corynebacterium diphtheriae

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