Diphtheria physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Dima Nimri, M.D. [2]

## Overview

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A patient with diptheria usually looks ill, with such systemic signs as fever, tachypnea, and tachycardia. Pharyngeal, respiratory, neurologic, cardiac, and other physical examination findings may be present depending on the extent and severity of the infection.

## Physical Examination

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Some or all of the following physical findings may be present, depending on the extent of spread and severity of the diphtheria infection:[1][2][3]

Organ System  | Findings

|

General Appearance  | Ill-appearing
Vital Signs  | Fever
Tachycardia
Tachypnea
Skin  | Ulceration
HEENT  | Cervical adenopathy
Bull neck
Neck edema
Pseudomembranous tonsilloparyngeal exudates
Edema of tonsils and uvula
Rhinorrhea
Lungs  | Cough
Dyspnea
Hemoptysis
Stridor
Heart  | Sinus bradycardia
S3 gallop
Arrythmia
Distant heart sounds
Displaced PMI
Neurological  | Peripheral neuropathy
Cranial Nerve III, IX, X palsies
Paresis or Paralysis

## References

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1. ↑ Dobie RA, Tobey DN (1979). "Clinical features of diphtheria in the respiratory tract". JAMA. 242 (20): 2197–201. PMID 490806.
2. ↑ Kadirova R, Kartoglu HU, Strebel PM (2000). "Clinical characteristics and management of 676 hospitalized diphtheria cases, Kyrgyz Republic, 1995". J. Infect. Dis. 181 Suppl 1: S110–5. doi:10.1086/315549. PMID 10657201.
3. ↑ Kneen R, Nguyen MD, Solomon T, Pham NG, Parry CM, Nguyen TT, Ha TL, Taylor A, Vo TT, Nguyen TT, Day NP, White NJ (2004). "Clinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children". Clin. Infect. Dis. 39 (11): 1591–8. doi:10.1086/425305. PMID 15578357.

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