Corynebacterium diphtheriae

One-Sentence Definition

Corynebacterium diphtheriae is a Gram-positive rod whose toxigenic strains produce diphtheria toxin (via lysogenic phage), causing pseudomembranous pharyngitis and systemic toxicity — prevented by toxoid vaccination.

Taxonomy & Morphology

  • Club-shaped Gram-positive bacillus; metachromatic granules
  • Non-spore-forming; tellurite selective media (historical ID)

Virulence Highlights

  • Diphtheria toxin — ADP-ribosylates EF-2 → protein synthesis arrest
  • Toxin gene carried by β-phage (Transduction)
  • Non-toxigenic strains cause milder colonization/infection

Clinical Syndromes

  • Respiratory diphtheria — pseudomembrane, airway obstruction
  • Cutaneous diphtheria (tropical/travel)
  • Systemic toxin: myocarditis, neuropathy

Diagnosis

  • Culture from throat/lesion; toxin PCR/Elek test for toxigenicity
  • Do not delay antitoxin on culture if clinical suspicion high

Treatment / Prevention

  • Diphtheria antitoxin + antibiotics (penicillin/macrolide)
  • DTaP/Tdap toxoid vaccine (Vaccination)
  • Close contact monitoring and prophylaxis per public health

Active Recall

  1. What converts a non-toxigenic strain to toxigenic?
  2. Toxin molecular target?
  3. Why give antitoxin before culture returns?