Overall CT features are suggestive of acute tonsilitis with bilateral level II cervical lymphadenopathy. The diffuse enhancement of the Waldeyer ring may represent lymphoid hyperplasia as an inflammatory/infective response.

Corynebacterium diphtheriae was detected by bacterial culture and with positive findings by virulence test, this case was proven to be pharyngeal diphtheria. Further history revealed that she does not receive full vaccination.

Diphtheria is a serious bacterial infection that affects the mucous membranes of the nose and throat. Diphtheria is extremely rare in developed countries due to successful widespread vaccination against the disease. However, this disease is still prevalent in developing countries where vaccination uptake is lower.