2. MEMBRANOUS TONSILLIITIS
It occurs due to pyogenic organisms.
An exudative membrane forms over the medial
surface of the tonsils ,along with the features of
acute tonsillitis.
3. DIPHTHERIA
Diphtheria unlike acute tonsillitis slower in
onset,with less local discomfort.
The membrane in diphtheria extends beyond the
tonsils on to the soft palate and is dirty in colour.
Membrane is adherent and its removal leaves a
bleeding surface.
Urine may show albumin .
Smear and culture of throat swab will reveal
Corynebacterium diphtherae.
4.
5. VINCENT’S ANGINA
It is insidious in onset with less fever and less
discomfort in throat.
Membrane ,which usually forms over one tonsil
,can be easily removed.
Throat swab will show both the organisms typical of
disease ,namely fusiform bacilli and spirochaetes.
6. INFECTIOUS MONONUCLEOSIS
This often affects young adults.
Both tonsils are very much enlarged,congested and
covered with membrane.
Lymph nodes are enlarged in the posterior triangle
of neck along with splenomegaly.
Blood smear may show more than 50%
lymphocytes of which 10% are atypical.
WBC may be normal in the first week but rises in
the second week.
Paul Bunnell test will show hih titre of heterophil
antibody.
7. AGRANULOCYTOSIS
It presents with ulcerative necrotic lesion not only
the on the tonsils but elsewhere in the oropharynx.
Patient is severely sick.
In acute fulminant form ,total leucocyte count is
decreased to<2000/cu mm.
In chronic or recurrent form it is reduced to 2000/cu
mm with less marked granulocytopenia.
8. APHTHOUS ULCERS
They may involve any part of oral cavity or
oropharynx.
Sometimes ,it is solitary and may involve the tonsil
and pillars .
It may be small or quite large and alarming .it is
very painful also.
9. TRAUMATIC ULCER
Any injury to oropharynx heals by formation of a
membrane .
Trauma to the tonsil area may occur accidently
when hit with a tooth brush ,a pencil held in mouth
or fingering in the throat.
Membrane appear within 24 hours.
