● Thick grey pseudomembrane composed of fibrin epithelial cells, bacteria and 10 y/o boy with polymorp severe diphtheria neutrophils .conjunctivitis e Pseudomembrane ● pharyngeal membrane may cause blockage, ◆ bull neck suffocation ◆ severe myocarditis e all vaccines contraindicated CDC The cervical lymph nodes enlarge causing oedema of the neck(a classical condition of bullneck) Epidemiology e Largely controlled now by vaccination e However, factors such as poverty and other social factors have led to diphtheria being an endemic/epidemic in many regions of the orld