A 40-year-old homosexual man developed an episode of sore throat with cervical adenitis but remained afebrile. Prior to presentation, symptomatic treatments for laryngitis and gastric reflux disease had been unsuccessful. On examination, we observed bilateral tonsillitis accompanied by diffuse pharyngitis. The tonsils and faucial pillars were red, swollen, and tender on palpation, and they were coated with whitish patches with erythematous borders (Figure 1). The uvula and soft palate were less involved. The dorsal aspect of the tongue also had thick, whitish patches. In addition, marked bilateral cervical lymphadenopathy was present, and symmetrically disseminated papular syphilids were observed on the upper back.