Complications of Diphtheria
The complications of diphtheria can be severe and, in some cases, life-threatening. While early treatment reduces risks, the toxin produced by the bacteria can cause lasting damage to several vital systems. Heart, nerve, and kidney complications are the most serious outcomes of the disease, especially when diagnosis or treatment is delayed.
Myocarditis, or inflammation of the heart muscle, is one of the most feared complications of diphtheria. It can lead to abnormal heart rhythms, heart failure, or even sudden death. In some cases, heart damage occurs even after the throat symptoms begin to improve. For this reason, patients recovering from diphtheria require close monitoring, particularly during the second and third week of illness.
Neurological complications are also common. These may include paralysis of the throat muscles, leading to difficulty swallowing and breathing. In more serious cases, the paralysis can affect the diaphragm, which is essential for breathing. When this happens, mechanical ventilation may be needed. Recovery is possible but can take several weeks or months depending on the severity.
Another potential outcome is kidney injury. The diphtheria toxin can cause damage to the kidneys, leading to reduced function or even kidney failure in the most severe cases. This adds to the complexity of treatment and often requires hospital-based supportive care.
In children, additional complications of diphtheria include severe dehydration, bacterial pneumonia, and prolonged hospital stays. The stress on a child’s developing immune system and body can lead to further growth or developmental delays. These complications are more common in malnourished children or those with other underlying health conditions.
Cutaneous diphtheria, while less likely to result in death, can still lead to skin infections that spread or worsen without proper hygiene and medical care. In communities with limited healthcare access, this form of the disease can persist and contribute to broader transmission.
Complications of Diphtheria
In South Africa, outbreaks of diphtheria in under-immunised communities have highlighted the importance of strong public health infrastructure. Incomplete vaccination remains a major driver of severe complications, especially in informal settlements or remote rural areas where healthcare access is limited.
Long-term, individuals who survive severe complications of diphtheria may face ongoing health challenges such as persistent weakness, chronic heart problems, or speech difficulties. However, with rehabilitation and consistent medical care, many can return to a good quality of life.
Preventing these complications remains the priority. Through early diagnosis, aggressive treatment, and widespread immunisation, the world can reduce the long-term burden of this once-feared disease.


