The following symptoms and complaints may indicate diphtheria:
Leading symptoms of respiratory tract infection.
- Angina with adherent grayish-white coatings on the pharyngeal mucosa (pseudomembranes); bleeding occurs rapidly when an attempt is made to detach them
- Hoarseness (dysphonia) to aphonia (voiceless).
- Sore throat (due topharyngeal diphtheria)
- Barking cough (due tolaryngeal diphtheria) (rare).
- Inspiratory stridor (breathing sound when inhaling), with risk of suffocation.
- Lymphadenopathy (lymph node enlargement).
- Caesarean neck – swelling of the neck; can lead to respiratory distress attacks (croup/pseudocroup; due to acute stenosing laryngotracheitis/inflammation of the mucous membranes of the larynx and trachea).
- Unpleasant, sweetish foetor ex ore (bad breath).
- Fever (frequent)
- Severe feeling of illness
Bold: symptoms of croup syndrome; these are assigned to the following conditions:
- Diphtheric croup (= true croup) – Note: Occurrence at any age!
- Viral croup – most common cause of acute dyspnea (shortness of breath) in childhood (6th month of life (LM) – 3rd year of life (LJ)); incidence: about 5% in the 2nd year of life.
- Recurrent croup – typical causative agents/triggers: viruses, allergens, inhalant noxious agents; childhood (6 LM . 6th LY/peak 2nd LY).
- Bacterial laryngotracheitis – typical pathogens: Staphylococcus aureus, Haemophilus influenzae; occurrence: very rare; childhood (6th LM – 8 LJ/peak 6th LJ).