Corynebacterium diphtheriae causes -

Ans. is 'd' i.e., All of the above* Clinically diphtheria is divided into1) Facial (tonsillo-pharyngeal) diphtheria# It is the commonest type with incubation period of 2-5 days. There is thick adherent pseudomembrane (grey or white) on one or both tonsils or adjacent pharynx. Dislodging of membrane is likely to cause bleeding. A small perecentage of patient present with massive swelling of tonsils and uvula with cervical lymphadenopathy (bull neck) and severe toxemia, called malignant diphtheria.2) Laryngeal diphtheria# It is the most severe form of diphtheria.3) Nasal diphtheria# It is the mildest form.4) Cutaneous diphtheria# It is caused by nontoxigenic strain and patient presents with "punched out" ulcer.5) Other forms# These are conjunctival, otitic, genital (vulval, vaginal or prepucial), and gastrointestinal.* Complications of diphtheria are obstruction due to pseudomembrane, myocarditis, polyneuropathy, post- diphtheric paralysis and pneumonia.* Post-diphtheric paralysis occurs in 3rd or 4th week and characterized by palatine and pupillary paralysis with complete recovery after sometime. There is isolated cranial nerve (isolated ocular) paralysis.* Less common complications of diphtheria are renal failure, encephalitis, cerebral infarction, pulmonary embolism and bacteremia or endocarditis.