'Bull neck' in Diphtheria is due to -

Ans. is `d' i.e., Lymphadenopathy Clinical manifestations of diphtheria A) Faucial (tonsillo pharyngeal) diphtheria o It is the commonest type of diphtherial infection. o Incubation period is 2-5 days. o Patients present with malaise, sore throat and moderate fever. o A thick adherent pseudomembrane (gray or white) is present on one or both tonsils or adjacent pharynx. o Dislodging the membrane is likely to cause bleeding. o A small percentage of patients present with massive swelling of the tonsils and uvula with cervical lymphadenopathy (bull neck) and severe toxemia --> Malignant diphtheria. Systemic toxicity (toxemia) is usually most severe when pseudomembrane extends from tonsil and pharynx (faucial diphtheria) to adjacent areas. B) Laryngeal diphtheria o Presents as hoarseness and cough. o It is the most severe form of respiratory diphtheria. Trocheostomy may be required. C) Nasal diphtheria o Presents with unilateral or bilateral nasal discharge. o Mildest form of respiratory diphtheria D)Cutaneous diphtheria Caused by nontoxigenic strains o Presents as distinct "punched out" ulcers. o More common in tropical areas. o Other less common type of diphtheria are con juctival, otitic, genital - (vulval, vaginal or prepucial), gastrointestinal.