Kneen et al developed a clinical severity score for describing the severity of diphtheria in Vietnamese children. The authors are from the Centre for Tropical Diseases in Ho Chi Minh City, Vietnam, and John Radcliffe Hospital in Oxford, England.
Clinical Appearance
Severity
asymptomatic
normal
local symptoms only (pharyngitis, etc.)
mild
systemically ill with toxic facial appearance
moderate
one or more critical symptoms (see below)
severe
Critical symptoms:
(1) bed bound
(2) unable to drinking
(3) difficulty breathing
(4) change in mental status
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