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Diphtheria is caused by toxin producing strains of gram positivebacilli Corynebacterium diphtheriae. Epidemics occur when immunization coverage is inadequate. The characteristic pseudomembrane of diphtheria is formed by necrotic tissue, inflammatory exudates, fibrin and colonies of the organism and bleeds on removal. Other differentials of membranous tonsillitis include infectious mononucleosis, streptococcal pharyngitis and Vincent’s angina. Diphtheria should be considered in all cases of membranous tonsillitis in the appropriate epidemiological background, and antitoxin treatment should be initiated promptly.
