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[Tonsils in diphtheria and the Corynebacterium diphtheriae carrier state]
Abstract:
Investigations of 16 archive autopsy observations of diphtheria of the fauces confirmed bacteriologically revealed that Corynebacteria diphtheriae multiplied mainly on the surface of the mucous membrane. Fibrinous inflammation on the tonsillar surface is most typical for this agent. In all cases with manifestations of acute inflammation the lesion was caused by C. diphtheriae in combination with other bacteria, most frequently streptococci. The latter were harboured deep in the tonsills and caused there an inflammatory process with characteristic lesions. Examinations of the tonsills removed from 72 C. diphtheriae carriers showed that longterm persistence of the bacteria in the tonsills was primarily due to the specific structure of the cryptae, particularly great branchiness and depth contributing to the retention of the content. Long-term carrier state leads to a statistically significant increase of the degree of their plasmatization as compared with the control group. This occurs in parallel with changes in the general responsiveness of the host.
Insights
Corynebacterium diphtheriae primarily colonizes the mucous membrane surface, often with streptococci causing deeper infections. Tonsil crypt structure facilitates long-term diphtheria pathogen persistence.
Area of Science:
- Microbiology
- Pathology
- Infectious Diseases
Background:
- Diphtheria is a serious bacterial infection caused by Corynebacterium diphtheriae.
- Understanding the pathogen's interaction with host tissues is crucial for disease control.
Purpose of the Study:
- To investigate the localization and host-tissue interactions of Corynebacterium diphtheriae in faucial diphtheria.
- To identify factors contributing to the long-term carrier state of C. diphtheriae.
Main Methods:
- Analysis of 16 autopsy cases of diphtheria of the fauces with bacteriological confirmation.
- Examination of tonsils from 72 C. diphtheriae carriers.
- Histopathological assessment of tonsillar tissue, including crypt structure and inflammatory response.
Main Results:
- Corynebacterium diphtheriae predominantly multiplies on the mucous membrane surface, with fibrinous inflammation on the tonsillar surface being characteristic.
- Acute inflammation involved C. diphtheriae in conjunction with other bacteria, notably streptococci, which caused deeper lesions.
- Specific tonsillar crypt morphology (branchiness, depth) was identified as a key factor in long-term C. diphtheriae persistence.
- Long-term carriers exhibited increased tonsillar plasmatization, correlating with altered host responsiveness.
Conclusions:
- The surface colonization and specific crypt structure are critical for C. diphtheriae pathogenesis and persistence.
- Co-infection with other bacteria, like streptococci, contributes to the severity of acute diphtheria.
- Understanding these mechanisms can inform strategies for managing diphtheria and carrier states.