What is a Diphtheria Toxin?

D. Jeffress

Diphtheria toxin is a chemical that is secreted by an infectious bacterium called Corynebacterium diphtheriae, or C. diphtheriae. When a person inhales C. diphtheriae spores, they imbed in the throat and respiratory tract and begin to release toxins. If the immune system is not strong enough to suppress the toxins, a potentially life-threatening infection occurs. Diphtheria has largely been eradicated in developed countries due to vaccination efforts, but the disease still affects thousands of people a year in poorer regions without access to quality health-care.

Frequent nose bleeds can indicate that diphtheria toxin is spreading through the bloodstream.
Frequent nose bleeds can indicate that diphtheria toxin is spreading through the bloodstream.

Extensive medical research has been performed on C. diphtheriae and the diphtheria toxin. The bacteria is found worldwide, and it is most prevalent in temperate climates. Most infections occur when pathogens become airborne and are inhaled by a host. Once inside the body, C. diphtheriae spores attach to the mucous membranes lining the lungs, airways, and throat. The bacteria is highly contagious, and an individual can contract it after being in close contact with an infected person.

A diphtheria toxin can lead to partial or total muscle paralysis.
A diphtheria toxin can lead to partial or total muscle paralysis.

Diphtheria toxin is not always released by C. diphtheriae, and non-active infections generally do not cause health problems. Certain strains of the bacteria can be activated by iron from the bloodstream, however, causing toxins to be excreted. Toxic effects are initially isolated to the original site of infection, and can result in a sore throat, cough, hoarseness, and breathing difficulties.

Penicillin may be given to a patient to help prevent secondary infections.
Penicillin may be given to a patient to help prevent secondary infections.

Over the course of several hours or days, diphtheria toxin begins to spread throughout the bloodstream to other parts of the body. A person may develop skin lesions, sinus congestion, and frequent bloody noses. If diphtheria toxin reaches the heart, it can cause severe inflammation and swelling that raises blood pressure and presents the risk of heart attack. Rarely, toxins in the nervous system can lead to partial or total muscle paralysis.

Effects of diphtheria toxin may include sore throat.
Effects of diphtheria toxin may include sore throat.

A person who shows possible symptoms of diphtheria should be evaluated by a doctor as soon as possible. Blood and sputum tests can confirm the presence of C. diphtheriae and indicate whether or not toxins have been released. A synthetic antitoxin can be injected directly into the bloodstream that cancels out the effects of the toxin. In addition, penicillin and other antibiotics are given to help prevent secondary infections. Patients in critical condition may need oxygen therapy and careful heart monitoring to prevent serious complications.

When antitoxin solutions are readily available, most cases of diphtheria can be cured. The best treatment, however, is preventing infection in the first place and minimizing the risks of an epidemic. A diluted form of diphtheria toxin is used as part of a routine childhood vaccination schedule in most countries. Adults who have never had diphtheria can also receive the vaccination.

A person may develop skin lesions as a result of diphtheria toxin.
A person may develop skin lesions as a result of diphtheria toxin.

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Discussion Comments

anon156942

My immunized child tested positive for diphtheria after a swab. It does not seem right to me that she can get is after being immunized. She is nine years old. Apart from taking a course of antibiotics, nothing else has really been done. Is it possible for the throat culture to be a false positive.

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