Overview
Introduction: When a Sore Throat Becomes an Airway Emergency
A patient with a sore throat, low grade fever, hoarse voice, and a grey white membrane in the throat may not look severely ill at first.
A patient with a sore throat, low-grade fever, hoarse voice, and a grey-white membrane in the throat may not look severely ill at first. The experienced nurse notices the dangerous combination: an adherent membrane that can extend downward and toxin that can later injure the heart and peripheral nerves. Suspected respiratory diphtheria is therefore managed as an airway and public-health emergency. Place the patient in appropriate isolation, move assessment to a setting with immediate intubation or surgical-airway capability, notify the provider and public health, collect cultures before antimicrobials when this will not delay care, and arrange diphtheria antitoxin immediately. Do not wait for laboratory confirmation and do not scrape the membrane.