Overview
Pharyngeal diphtheria is a contagious infection caused by Corynebacterium diphtheriae, characterized by a pseudomembrane formation in the pharynx, potentially leading to airway obstruction and systemic complications 1.Diagnosis
Clinical presentation includes sore throat, fever, and a characteristic grayish-white pseudomembrane in the pharynx 1.
Microbiological confirmation through throat swab cultures for Corynebacterium diphtheriae 1.
Laboratory tests may include elevated white blood cell count and inflammatory markers 1.Management
Antibiotics: Penicillin or erythromycin for primary treatment to eradicate the organism 1.
Sedation for Endoscopy: Pethidine hydrochloride (35 mg intravenously) is recommended over no sedation or midazolam for better pharyngeal observation during transoral endoscopy, improving visualization scores 1.Special Populations
No specific recommendations provided for pregnancy, pediatrics, elderly, or comorbidities based on the given abstracts 1.Key Recommendations
Use pethidine hydrochloride (35 mg intravenously) for sedation during transoral endoscopy to enhance pharyngeal visualization 1 (Evidence: Strong).
Initiate antibiotic therapy with penicillin or erythromycin for confirmed diphtheria cases to ensure eradication of Corynebacterium diphtheriae 1 (Evidence: Strong).
Consider elevated inflammatory markers and white blood cell counts in the diagnostic workup for suspected pharyngeal diphtheria 1 (Evidence: Moderate).References
1 Yamasaki Y, Ishihara R, Hanaoka N, Matsuura N, Kanesaka T, Akasaka T et al.. Pethidine hydrochloride is a better sedation method for pharyngeal observation by transoral endoscopy compared with no sedation and midazolam. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 2017. link