Diphtheritic stomatitis

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Diphtheritic stomatitis
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Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Sore throat, fever, pseudomembrane formation in the mouth
Complications	Breathing difficulties, myocarditis, neuropathy
Onset
Duration
Types	N/A
Causes	Corynebacterium diphtheriae
Risks	Lack of vaccination, close contact with infected individuals
Diagnosis	Clinical examination, culture of the bacteria
Differential diagnosis	N/A
Prevention	Diphtheria vaccine
Treatment	Antibiotics, Diphtheria antitoxin
Medication	N/A
Prognosis	N/A
Frequency	N/A
Deaths	N/A

Diphtheritic stomatitis is an infectious condition characterized by the inflammation of the mucous membranes in the mouth due to infection with the bacterium Corynebacterium diphtheriae. This condition is a manifestation of diphtheria, a serious bacterial infection that primarily affects the mucous membranes of the respiratory tract but can also involve the skin and other mucosal surfaces.

Pathophysiology

Diphtheritic stomatitis occurs when Corynebacterium diphtheriae infects the oral mucosa. The bacterium produces a potent exotoxin that inhibits protein synthesis in host cells, leading to cell death. This results in the formation of a thick, gray pseudomembrane on the mucosal surfaces, which is a hallmark of diphtheritic infections. The pseudomembrane can cause significant obstruction and discomfort in the oral cavity.

Clinical Presentation

Patients with diphtheritic stomatitis typically present with:

• Sore throat
• Fever
• Malaise
• Difficulty swallowing
• The presence of a thick, gray pseudomembrane in the mouth, which may bleed when scraped

In severe cases, the toxin can spread systemically, leading to complications such as myocarditis, neuropathy, and airway obstruction.

Diagnosis

The diagnosis of diphtheritic stomatitis is primarily clinical, based on the characteristic appearance of the pseudomembrane. Confirmation is achieved by isolating Corynebacterium diphtheriae from throat swabs or cultures. Polymerase chain reaction (PCR) tests can also be used to detect the presence of the diphtheria toxin gene.

Treatment

The mainstay of treatment for diphtheritic stomatitis includes:

• Administration of diphtheria antitoxin to neutralize the circulating toxin.
• Antibiotic therapy, typically with penicillin or erythromycin, to eradicate the bacterial infection.
• Supportive care, including maintaining airway patency and hydration.

Prevention

Prevention of diphtheritic stomatitis is primarily through vaccination. The diphtheria vaccine, often given in combination with tetanus and pertussis vaccines (DTaP or Tdap), is highly effective in preventing diphtheria infections.

Epidemiology

Diphtheritic stomatitis is rare in countries with high vaccination coverage. However, it remains a concern in areas where vaccination rates are low or where outbreaks of diphtheria occur.

Also see

• Diphtheria
• Corynebacterium diphtheriae
• Pseudomembranous inflammation
• Vaccination