Discussion

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Necrotic patch visible as white membrane on left tonsil and a grey patch on the inner pillar of right tonsil in a 7 year boy suffering from DIPHTHERIA. The swelling over left angle of mandible and near right tragus suggest beginning of lymphnode enlargement which can grow large enough to be called 'bull neck'.
Membrane may extend down to glottis causing stridor and respiratory obstruction requiring tracheostomy. Exotoxins reach myocardium and invariably cause myocarditis simultaneuosly. Cardiac markers are elevated. This child was not immunised with diphtheria (DPT) vaccine. The serious symptoms like respiratory obstruction and stridor are not seen in this child perhaps due to partial immunity from previous asymptomatic infections.
Neurological complications like muscle paralysis, nasal voice or post infectious polyneuropathy (GBS- Gullian Barry syndrome) can occur after 2 weeks to 6 months later.
Therefore, not giving a vaccine leads to complications that are life treatening (tracheal obstruction, myocarditis), require expensive treatment like ventilator and/or immunoglobulins.
Other causes of white membrane in oral cavity are infectious mononucleosis, streptococci, candida, submucus fibrosis and lichen planus (due to tobacco chewing), poor oral toilet esp with tonsilar cleft.

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Competing Interests

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Disclaimer

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This article has been downloaded from WebmedCentral. With our unique author driven post publication peer review, contents posted on this web portal do not undergo any prepublication peer or editorial review. It is completely the responsibility of the authors to ensure not only scientific and ethical standards of the manuscript but also its grammatical accuracy. Authors must ensure that they obtain all the necessary permissions before submitting any information that requires obtaining a consent or approval from a third party. Authors should also ensure not to submit any information which they do not have the copyright of or of which they have transferred the copyrights to a third party.
Contents on WebmedCentral are purely for biomedical researchers and scientists. They are not meant to cater to the needs of an individual patient. The web portal or any content(s) therein is neither designed to support, nor replace, the relationship that exists between a patient/site visitor and his/her physician. Your use of the WebmedCentral site and its contents is entirely at your own risk. We do not take any responsibility for any harm that you may suffer or inflict on a third person by following the contents of this website.