Which feature is most characteristic of diphtheritic pharyngitis?

Which feature is most characteristic of diphtheritic pharyngitis?

• A. Sore throat with grey membrane in the throat and swollen lymph nodes.
• B. Sore throat with red, non-membranous pharyngitis.
• C. Sore throat with white patches on the tonsils but no membrane.
• D. Sore throat with a thick purulent discharge from the ears.

Answer: (D)

The hallmark of diphtheritic pharyngitis is a gray, adherent pseudomembrane covering the pharynx and tonsils, often with tender cervical lymphadenopathy. This membrane forms from toxin-mediated necrosis of the mucosa and is the distinctive feature that sets diphtheria apart from other causes of sore throat. The membrane may be difficult to remove and can lead to airway obstruction in severe cases, emphasizing why it’s the key finding. In contrast, red, non-membranous pharyngitis suggests other infections, white patches without a membrane point to different etiologies like candidiasis or simple tonsillitis, and purulent ear discharge indicates otitis media rather than diphtheria. Hence, the gray pseudomembrane with lymph node involvement best characterizes diphtheritic pharyngitis.

The hallmark of diphtheritic pharyngitis is a gray, adherent pseudomembrane covering the pharynx and tonsils, often with tender cervical lymphadenopathy. This membrane forms from toxin-mediated necrosis of the mucosa and is the distinctive feature that sets diphtheria apart from other causes of sore throat. The membrane may be difficult to remove and can lead to airway obstruction in severe cases, emphasizing why it’s the key finding. In contrast, red, non-membranous pharyngitis suggests other infections, white patches without a membrane point to different etiologies like candidiasis or simple tonsillitis, and purulent ear discharge indicates otitis media rather than diphtheria. Hence, the gray pseudomembrane with lymph node involvement best characterizes diphtheritic pharyngitis.