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| |    Complications of Diphtheria by Lynn Cates, M.D., F.A.A.P. reviewed by Laura Jana, M.D., F.A.A.P. Diphtheria is a very serious disease that, if not diagnosed and treated promptly, can result in many complications, either from the infection itself or from a potent toxin (poison) produced by the bacterium Corynebacterium diphtheriae. Anyone who is not fully immunized with diphtheria toxoid vaccine is at risk of this disease and its potentially serious complications, which include: Myocarditis Myocarditis is inflammation of the heart muscle that can cause an irregular heartbeat and lead to heart failure. It often is fatal. Neuritis Neuritis is inflammation of the nerves than can cause paralysis of any part of the body. Diphtheria toxin often affects the back of the roof of the mouth (the soft palate), and it can affect eye and limb muscles as well as the diaphragm (the muscle that separates the chest from the abdomen and helps with breathing). Difficulty swallowing and breathing Soft-palate paralysis prevents normal swallowing and can lead to choking or aspiration of food into the lungs, causing aspiration pneumonia. Paralysis of the diaphragm can lead to difficulty breathing, pneumonia, and even respiratory failure and death. In addition, the membrane at the back of the throat or in the voice box can partially or completely block the airway, resulting in suffocation. Pneumonia Pneumonia can result from the infection itself, or it can be secondary to the swallowing and breathing difficulties described above. Kidney failure The toxin produced by Corynebacterium diphtheriae can cause kidney failure directly, or kidney failure can develop secondarily as a complication of heart failure. Death The mortality rate is about 5 to 10 percent, although it can climb as high as 20 percent in children under the age of five years. In recent years, the mortality rate in diphtheria epidemics in the independent states of the former Soviet Union has ranged from 3 to 23 percent.
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