What should you know about diphtheria paralysis?

The toxin can injure nerves after the throat infection begins. Weakness may affect the soft palate, causing a nasal voice or difficulty swallowing, and can later involve the eyes, limbs, or breathing muscles. A person may remain alert while movement becomes harder. Diphtheria can begin with a sore throat; see Sore Throat for symptom context.

Paralysis is not the same as tiredness. New trouble swallowing, speaking clearly, walking, lifting the head, or taking a full breath should be described promptly to a clinician.

Seek same-day medical care if diphtheria is suspected or weakness is developing. Treatment may include diphtheria antitoxin, antibiotics, monitoring, and help with breathing or swallowing. Antibiotics help stop the bacteria spreading, but they do not reverse toxin already attached to nerve tissue; see Antibiotic Treatment for general information. Avoid close contact until a clinician gives clearance, and do not share cups or utensils.

Call emergency services immediately for shortness of breath, pauses in breathing, choking, inability to swallow saliva, rapidly worsening weakness, blue lips, or collapse. A person with suspected diphtheria may need hospital observation even if the throat symptoms seem to be settling.

Ask whether weakness could be toxin-related, which examinations will track swallowing and breathing, how long isolation is needed, and whether household contacts need testing, antibiotics, or vaccination.