. Diseases of infancy and childhood . ily until the disease can positively be excluded. The cervical glandsare usually swollen. Thrush sometimes resembles diphtheria, but can be differentiated bythe fact that the small, whitish spots resembling curdled milk are scatteredover the cheeks, lips, tongiie, ard gimis, in addition to the uvula andpharynx. DIPHTHERIA. 521 Ulcerative tonsillitis^ resembling diphtheria has been described by Vin-cent. In this condition there is no tendency to spread. There is an absenceof croup, and a culture taken shows the Vincent bacillus instead of theKlebs-Loeffler
. Diseases of infancy and childhood . ily until the disease can positively be excluded. The cervical glandsare usually swollen. Thrush sometimes resembles diphtheria, but can be differentiated bythe fact that the small, whitish spots resembling curdled milk are scatteredover the cheeks, lips, tongiie, ard gimis, in addition to the uvula andpharynx. DIPHTHERIA. 521 Ulcerative tonsillitis^ resembling diphtheria has been described by Vin-cent. In this condition there is no tendency to spread. There is an absenceof croup, and a culture taken shows the Vincent bacillus instead of theKlebs-Loeffler bacillus. Peritonsillar Ahscess.—In this condition we meet with a swelling orbulging forward of the affected parts. The uvula is sometimes are very many active local symptoms, such as pain and dijSicultyin swallowing, and a nasal tone of voice. Not infrequently when an at-tempt to swallow is made tlie fluid regurgitates through the nose. Whenchildren are old enough to describe subjective symptoms, they will complain. Fig. 165.—Pneumonia Complicating Diphtheria. (Kind assistance ofDr. Edward H. Sparkman, Jr., at the Wilhird Parker Hospital.) point of pneumonia, showing extent on third day. B. Focuswhich developed three days after A, sliowing extent on third day of thenew focus. (Original.) of chills and fever. The temperature is usually high, ranging from 102° to105° F. The active symptoms subside the moment pus is relieved. Naturefrequently gives a spontaneous evacuation of the pus. At other times it iswiser to give relief by making an incision and emptying the pus. A culturetaken in this condition does not show the presence of the Klebs-Loeftlerbacillus. Follicular TomiUifis.—hi this condition more than in ani/ other formof disease we must he careful regarding a pos-itive opinion. There arcfollicular forins of diphtheria in vol ring the lacuiuv of the tonsils whichclinically so resemble diphlheria Hint even an expert cannot differentiatethem.
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