What is the treatment of diphtheria in Indonesia
4hw.org: the Chinese Embassy in Indonesia issued a notice on the 12th, reminding Chinese citizens and institutions in Indonesia to pay attention to the prevention of diphtheria. Diphtheria is a very serious respiratory infectious disease, but how to prevent it? How to treat it? Let's take a look.
According to Xinhua news agency, Jakarta, December 12 (Zheng Shipo), the Chinese Embassy in Indonesia issued a notice on December 12, reminding Chinese citizens and institutions in Indonesia to pay attention to the prevention of diphtheria.
The announcement said that according to local media reports, the recent outbreak of diphtheria in Indonesia has caused nearly 600 infections and dozens of deaths, and there is a high risk of disease in densely populated Jakarta and surrounding provinces.
Diphtheria is an acute respiratory infectious disease caused by diphtheria bacilli. The infection channels include close contact with patients or air transmission. Its symptoms include fever, hoarseness, barking cough and white pseudomembrane in throat, tonsil and its surrounding tissues. The patients with serious disease can cause poisoning symptoms, myocarditis and peripheral nerve paralysis.
The Chinese Embassy in Indonesia reminded Chinese citizens and institutions in Indonesia to pay close attention to the outbreak of diphtheria and try to avoid going to densely populated places. If necessary, you can go to the local authorities for vaccination in time. If the above symptoms are found, they should be isolated immediately and treated in a regular hospital.
What is diphtheria
Diphtheria is an acute respiratory infectious disease caused by diphtheria. It is characterized by fever, suffocation of breath, hoarseness of voice, barking like cough, white pseudomembrane in pharynx, tonsil and surrounding tissues. In severe cases, the symptoms of systemic poisoning are obvious, and myocarditis and peripheral nerve palsy may occur.
The leukocyte count slightly increased, and the percentage of neutrophils increased (about 0.80).
2. Bacteriological examination
(1) we found Corynebacterium with different staining particles on the swab smear of pharyngeal and nasal mucosa.
(2) fluorescent antibody staining was positive.
(3) the bacterial culture of nasopharynx swab or the material from the affected area was used to culture diphtheria, and the virulence test was positive.
III. treatment measures and methods of diphtheria
1. General treatment
The patients should rest in bed and reduce activities, generally no less than 3 weeks, the patients with extensive pseudomembrane extended to 4-6 weeks, and pay attention to oral and nasal hygiene.
2. Antibiotic treatment
Antibiotics can inhibit the growth of diphtheria bacteria and prevent the production of toxins. Penicillin is often used for about 7-10 days, until the symptoms disappear and the culture of diphtheria bacteria turns negative. Erythromycin can be used for those who are allergic to penicillin or who are still positive after penicillin application for one week. The dosage is 40mg / (kg & middot; d), which can be taken orally or intravenously for four times. The course of treatment is the same as that of ampicillin, Equality of interests and blessings may also work.
3. Antitoxin therapy
Antitoxin can neutralize the free toxin, but can not neutralize the combined toxin. The effect is better when it is applied on the first three days of the course of the disease, and then the effect will be significantly reduced. Therefore, it should be used as early as possible. The dosage depends on the scope, location and treatment time of the pseudomembrane. The pseudomembrane of pharyngeal diphtheria is limited in the flat peach body, and it is given 20000-40000 u; the pseudomembrane is widely used, and it is given 40000-100000 u for the patients with severe poisoning symptoms; it is given to the patients with larynx, diphtheria and nose The patients with diphtheria were given 10000-30000 U. the dosage of the patients was doubled 3 days after the onset of the disease. The antitoxin could be injected intramuscularly or diluted and intravenous drip. After one administration, the patients with the disease continued to expand 24 hours later could be injected with the same amount of intramuscular injection. Before the injection of antitoxin, the allergy history should be inquired and the skin allergy test should be conducted. The patients with negative test can be used. The patients with positive test should be given according to the desensitization method.
4. Treatment of myocarditis
The patients should rest in bed. The patients who are agitated should be given sedatives. Prednisone can be used for 20-40mg / day. The dosage can be reduced gradually after the symptoms get better. The patients who are serious can use adenosine triphosphate (ATP) 20mg, coenzyme a50u, dissolved in 5% - 10% glucose solution 50-100ml for intravenous drip.
5. Treatment of nerve paralysis
Those with dysphagia should be fed by nose.
6. The treatment of laryngeal obstruction. The patients with mild laryngeal obstruction need to observe the development of the disease closely. They should be ready for tracheotomy at any time. It is difficult to breathe. In case of three concavities, tracheotomy should be carried out immediately, and the pseudomembrane should be removed at the incision, or trypsin or chymotrypsin should be dropped to dissolve the pseudomembrane.
7. Treatment of diphtheria carriers
The virulence test of diphtheria bacilli should be carried out first. The positive ones should be isolated and treated with penicillin or erythromycin. The dose is the same as before, and antitoxin is not necessary. The isolation should be relieved after three times of negative culture. Tonsillectomy can be considered for the stubborn carriers. If tonsillectomy is needed for the carriers in the recovery period of diphtheria, it must be carried out 3 months after recovery and when the heart is completely normal.