Which sign is classically associated with diphtheria infection?

Which sign is classically associated with diphtheria infection?

• A. Koplik spots
• B. Strawberry tongue
• C. Petechiae with palms
• D. Bull neck

Answer: (D)

Diphtheria classically presents with severe cervical lymphadenopathy and edema, giving a thick, swollen neck often described as a “bull neck.” This externally visible sign comes from extensive inflammation and enlargement of lymph nodes in the neck driven by the infection and toxin effects. While a pseudomembrane over the tonsils and pharynx is a hallmark of diphtheria, the prominent external feature clinicians historically rely on is this nodal-driven neck swelling. Koplik spots are white-yellow lesions on the buccal mucosa seen with measles. Strawberry tongue is described in scarlet fever and Kawasaki disease, reflecting different processes. Petechiae on the palms point to other infections such as meningococcemia or certain rickettsial illnesses. Thus, the bull neck best fits the classic sign associated with diphtheria.

Diphtheria classically presents with severe cervical lymphadenopathy and edema, giving a thick, swollen neck often described as a “bull neck.” This externally visible sign comes from extensive inflammation and enlargement of lymph nodes in the neck driven by the infection and toxin effects. While a pseudomembrane over the tonsils and pharynx is a hallmark of diphtheria, the prominent external feature clinicians historically rely on is this nodal-driven neck swelling.

Koplik spots are white-yellow lesions on the buccal mucosa seen with measles. Strawberry tongue is described in scarlet fever and Kawasaki disease, reflecting different processes. Petechiae on the palms point to other infections such as meningococcemia or certain rickettsial illnesses. Thus, the bull neck best fits the classic sign associated with diphtheria.