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The picture on the left shows a 29 year old female patient with acute exudative tonsillitis.   She had symptoms for only three days and did not respond to antibiotics.  Although the tonsils are enlarged and covered with pus, there is no distension of the anterior pillar or deviation of the uvula.  Thus, a peritonsillar abscess was not suspected.  The course and appearance of the tonsils raised the possibility of an early presentation of mononucleosis.