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Table 1 Distinguishing options of acute follicular tonsillitis and diphtheria Features Acute follicular tonsillitis Diphtheria previous history Recurrent sore throat with fever Contact with diphtheria patient Diphtheria vaccination taken Not taken Age No age bar Children Onset Acute Insidious throat ache Severe gentle Fever High grade Low grade Hoarseness of voice and respiratory Never present in advanced disease misery Neck bull due to cervical Absent Not unusual lymphadenopathy pulse fee In proportion to fever Out of proportion to fever and weak toxemia Absent current in superior illness tonsillar membrane Limited to tonsil and easily May prolong adjacent structures, and diffcult to removed remove, and leaves uncooked bleeding space throat swab Streptococci Corynebacterium diphtheriae Urine No albumin Albumin often current First line of remedy Antibiotics Antidiphtheric serum mortality Nil High Clinical options Clinical features 427 fi the afected crypt gradually enlarges, and will ulcerate on fi Discomfort on swallowing medial surface of tonsil. 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