eMedicine Specialties > Ophthalmology > Infectious Disease

Diphtheria: Follow-up

Author: Andrew A Dahl, MD, Director of Ophthalmology Teaching, Mid-Hudson Family Practice Institute, The Institute for Family Health; Assistant Professor of Surgery (Ophthalmology), New York College of Medicine
Contributor Information and Disclosures

Updated: Nov 17, 2008

Follow-up

Further Outpatient Care

  • Patients should receive follow-up care until the conjunctivitis is resolved.

Deterrence/Prevention

  • From 1991 through 1998, there was a massive epidemic of diphtheria in the Independent States of the Former Soviet Union, representing the first large-scale diphtheria outbreak in developed countries in more than 30 years. This occurred because of vaccine shortages and laxity in diphtheria immunization programs. Beginning in 1995, aggressive control strategies were implemented through mass vaccination with diphtheria toxoid, resulting in a major decrease in new cases of diphtheria by 2000.
  • See related CME at Guidelines Issued on Pertussis, Tetanus, Diphtheria Prevention in Pregnant Women and Newborns.

Complications

  • With severe respiratory involvement, death can occur.
  • Optic neuritis has been reported as a possible rare complication of diphtheria immunization.

Prognosis

  • The prognosis is favorable if detected early in the disease.

Miscellaneous

Medicolegal Pitfalls

  • Although diphtheria is not endemic in the United States, do not fail to think of it when seeing patients outside the country or when examining patients who have recently arrived from nations in the third world.
 


More on Diphtheria

Overview: Diphtheria
Differential Diagnoses & Workup: Diphtheria
Treatment & Medication: Diphtheria
Follow-up: Diphtheria
References
[ CLOSE WINDOW ]

References

  1. Burkhard C, Choi M, Wilhelm H. [Optic neuritis as a complication in preventive tetanus-diphtheria-poliomyelitis vaccination: a case report]. Klin Monatsbl Augenheilkd. Jan 2001;218(1):51-4. [Medline].

  2. Chandler JW, Milam DF. Diphtheria corneal ulcers. Arch Ophthalmol. Jan 1978;96(1):53-6. [Medline].

  3. Coachman J. Diphtheric conjunctivitis. Mer J Ophth. 1951;34:1176.

  4. Dittmann S, Wharton M, Vitek C, et al. Successful control of epidemic diphtheria in the states of the Former Union of Soviet Socialist Republics: lessons learned. J Infect Dis. Feb 2000;181 Suppl 1:S10-22. [Medline].

  5. Fuchs E. Textbook of Ophthalmology. 1889.

  6. Hardy IR, Dittmann S, Sutter R. Current situation and control strategies for resurgence of diphtheria in Newly Independent States of the former Soviet Union. Lancet. 10/1996;347:1739-1744.

  7. [Best Evidence] Pichichero ME, Rennels MB, Edwards KM, et al. Combined tetanus, diphtheria, and 5-component pertussis vaccine for use in adolescents and adults. JAMA. Jun 22 2005;293(24):3003-11. [Medline].

  8. Rolleston JD. Diphtheric paralysis. Arch Pediatr. 1913;30:335-45.

  9. Rolleston JD, Ronaldson GW. Acute Infectious Diseases. 1940.

  10. Tharmaphornpilas P, Yoocharoan P, Prempree P, et al. Diphtheria in Thailand in the 1990s. J Infect Dis. Oct 15 2001;184(8):1035-40. [Medline].

  11. Walshe FMR. On the pathogenesis of diphtheric paralysis. Q J Med. 1918-19;12:14-37.

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

diphtheria, conjunctivitis diphtheritica, Corynebacterium diphtheriae, C diphtheriae, keratoconjunctivitis, motility disorders, conjunctival infection, viral conjunctivitis, membranous conjunctivitis, immunization

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Andrew A Dahl, MD, Director of Ophthalmology Teaching, Mid-Hudson Family Practice Institute, The Institute for Family Health; Assistant Professor of Surgery (Ophthalmology), New York College of Medicine
Andrew A Dahl, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Richard W Allinson, MD, Associate Professor, Department of Surgery, Texas A&M University Health Science Center; Senior Staff Ophthalmologist, Scott and White Clinic
Richard W Allinson, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Louis E Probst, MD, Medical Director of Refractive Surgery, Chicago, Madison, Milwaukee, and Windsor Centers, TLC the Laser Eye Centers
Louis E Probst, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, and International Society of Refractive Surgery
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.