Diphtheritic stomatitis

A condition characterized by inflammation of the mouth due to diphtheria infection

Diphtheritic stomatitis is an inflammatory condition of the mouth caused by the Corynebacterium diphtheriae bacterium, which is also responsible for the systemic disease known as diphtheria. This condition is characterized by the formation of a pseudomembrane in the oral cavity, leading to symptoms such as pain, swelling, and difficulty swallowing.

Pathophysiology

Diphtheritic stomatitis occurs when the Corynebacterium diphtheriae bacterium infects the mucous membranes of the mouth. The bacterium produces a potent exotoxin that causes local tissue destruction and inflammation. The hallmark of the infection is the formation of a thick, grayish pseudomembrane composed of dead cells, fibrin, and bacteria. This pseudomembrane can adhere tightly to the underlying tissues, making it difficult to remove without causing bleeding.

Clinical presentation

Patients with diphtheritic stomatitis typically present with:

• Sore throat and pain in the mouth
• Swelling of the oral mucosa
• Difficulty swallowing (dysphagia)
• Fever and malaise
• Presence of a grayish pseudomembrane in the mouth

Diagnosis

The diagnosis of diphtheritic stomatitis is primarily clinical, based on the characteristic appearance of the pseudomembrane in the oral cavity. Confirmation can be obtained by isolating Corynebacterium diphtheriae from throat swabs or cultures. In some cases, a polymerase chain reaction (PCR) test may be used to detect the presence of the diphtheria toxin gene.

Treatment

The treatment of diphtheritic stomatitis involves:

• Administration of diphtheria antitoxin to neutralize the toxin
• Antibiotic therapy, typically with penicillin or erythromycin, to eradicate the bacterial infection
• Supportive care, including pain management and hydration

Prevention

Vaccination is the most effective way to prevent diphtheritic stomatitis and diphtheria. The diphtheria vaccine is usually given in combination with tetanus and pertussis vaccines (DTaP) during childhood.

Complications

If left untreated, diphtheritic stomatitis can lead to serious complications, including:

• Airway obstruction due to the pseudomembrane
• Systemic spread of the toxin, leading to myocarditis and neuropathy

Related pages

• Diphtheria
• Corynebacterium diphtheriae
• Vaccination
• Infectious diseases