🧒 PaediatricsInfectious diseaseStudentInternResident

Diphtheria

Also known as: Corynebacterium diphtheriae infection

A toxin-mediated infection — a sore throat with a characteristic adherent grey pseudomembrane over the tonsils/pharynx, a 'bull-neck' from lymphadenopathy, and toxin-mediated myocarditis and neuropathy. Vaccine-preventable; give antitoxin early.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Unvaccinated or under-vaccinated children and adults; outbreaks occur where immunisation coverage is low.

Red flags — escalate / refer

Airway obstruction from the membrane, myocarditis (arrhythmia, heart failure), or neurological paralysis → emergency; do not delay antitoxin awaiting confirmation.

Work-up / diagnosis

1A clinical diagnosis (pseudomembrane, bull-neck) — treat on suspicion; confirm with swab culture/PCR.
2ECG and cardiac monitoring for myocarditis; notify immediately (a notifiable disease).

Management — overview

Give diphtheria antitoxin EARLY — it neutralises unbound toxin, so do not wait for laboratory confirmation.
Antibiotics (penicillin or a macrolide) to eradicate the organism; secure the airway; isolate.
Monitor and treat myocarditis/neuropathy; give post-exposure prophylaxis and vaccination to contacts; complete the patient's active immunisation. Prevention is DPT vaccination.

In-depthFull dosing & advanced protocol

Drug dosing

Diphtheria antitoxin (early) + antibiotics

Neutralise toxin; eradicate organism

Adult dose: Antitoxin per protocol (do not delay); penicillin/macrolide course
Route: IM/IV (antitoxin); oral/IV (antibiotics)

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

DPT vaccine (prevention)

Primary prevention and after recovery

Adult dose: Per national immunisation schedule
Route: IM

IAPIndian Academy of Pediatrics (IAP) — guidelines ↗

Antitoxin timing is everything

Antitoxin only neutralises unbound toxin — give it as early as possible.
Airway and cardiac monitoring are essential; treat and immunise contacts.
Natural disease does not confer immunity — vaccinate after recovery.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

Acute Gastroenteritis — ORS & ZincAcute diarrhoea (± vomiting), usually a self-limiting viral illness. The danger is dehydration; low-osmolarity ORS plus zinc are the evidence-based core of treatment.Neonatal SepsisA serious bloodstream infection in the first 28 days of life. The signs are non-specific — treat early and empirically; delay is dangerous.Febrile SeizureA seizure with fever in a young child (6 months–5 years) without CNS infection or another cause. It is usually benign, but exclude serious causes and support the family.

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Diphtheria antitoxin (early) + antibiotics

DPT vaccine (prevention)

📈 Antitoxin timing is everything

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Diphtheria antitoxin (early) + antibiotics

DPT vaccine (prevention)

📈 Antitoxin timing is everything

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Antitoxin timing is everything

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Antitoxin timing is everything

References