'Bull neck' in Diphtheria is due to –

Clinical manifestations of diphtheria A) Faucial (tonsillo pharyngeal) diphtheria It is the commonest type of diphtherial infection. The incubation period is 2-5 days. Patients present with malaise, sore throat and moderate fever. A thick adherent pseudo membrane (grey or white) is present on one or both tonsils or adjacent pharynx. Dislodging the membrane is likely to cause bleeding. A small percentage of patients present with massive swelling of the tonsils and uvula with cervical lymphadenopathy (bull neck) and severe toxaemia → malignant diphtheria. Systemic toxicity (toxaemia) is usually most severe when pseudo membrane extends from tonsil and pharynx (faucial diphtheria) to adjacent areas. B) Laryngeal diphtheria Presents as hoarseness and cough. It is the most severe form of respiratory diphtheria. Trocheostomy may be required. C) Nasal diphtheria Presents with unilateral or bilateral nasal discharge. The mildest form of respiratory diphtheria D)Cutaneous diphtheria Caused by nontoxigenic strains Presents as distinct "punched out" ulcers. More common in tropical areas. Other less common types of diphtheria are conjunctiva, otitis, genital - (vulval, vaginal or preputial), gastrointestinal.