Respiratory diphtheria, caused by toxigenic strains of the gram-positive bacillus Corynebacterium diphtheriae, is an upper respiratory tract disease characterized by a sore throat; mild fever; and gray-white pseudomembrane
on the tonsils, larynx, or pharynx.
The surface of the lesion was covered by yellowish-white pseudomembrane
Patients having at least one aphthous ulcer, defined as round or oval ulcers with a gray-white pseudomembrane
and an erythematous halo less than 5 mm in diameter were considered as RAS positive.
Eye involvement was found in 10 of the patients including severe conjunctivitis in association with pseudomembrane
in three patients.
The sloughed necrotic mucosa on the top creates a pseudomembrane
(hematoxylin-eosin, original magnification X40).
On post mortem examination, the small intestine, and eventually also the large intestine, is diffusely hemorrhagic and necrotic, sometimes with the presence of ulcers and pseudomembrane
In the center, there is usually an ulcerated area covered with fibrinous pseudomembrane
The time when the pseudomembrane
and the erythematous border were removed was regarded as the complete healing date.
8,54) Less common signs include pin-point (petechial) sub-conjunctival haemorrhages, and, in severe cases, pseudomembrane
formation, representing coagulated exudate that is loosely adhered to the palpebral conjunctiva.
If the patient had a neurological deficit, posterior longitudinal ligament was divided, pseudomembrane
compressing dura was removed and cord/ cauda equina was adequately decompressed.
In concert, the toxins lead to inflammation, formation of the pseudomembrane
, and the classic foul-smelling, watery stools.
In extreme cases, an extensive pseudomembrane
developed adjacent to the membranous layer of the cuticle.