A patient presented with pain in the gums,unilateral throat pain with neck swelling on the same side.On examination,inflammation with ulceration was present over the gums and following picture of throat was seen.
What is the most probable diagnosis?
A. Streptococcal Tonsilitis.
D. Vincent’s angina.
Ans:D. Vincent’s angina.
- It is an acute necrotizing infection of the pharynx caused by a combination of fusiform bacilli (Fusiformis fusiformis – a Gram -ve bacillus) and spirochetes (Borrelia vincentii ).
- These are the same organisms that cause a gingivostomatitis known as trench mouth.
- The patient genrally complains of unilateral sore throat with an associated referred earache on the same side.
- In addition, the patient complains of a bad taste in the mouth and a fetid bad breath.
- On examination, greyish membrane forms usually over one tonsils,which can be easily removed revealing an irregular ulcer on the tonsil which bleeds easily when scraped with a swab. There may also be an associated submandibular lymphadenopathy.
- Vincent angina is diagnosed using a gentian violet-stained smear of the pharyngeal exudate, which demonstrates the presence of Fusobacterium and spirochetes.
- Penicillin or Clindamycin and surgical debridement are the recommended treatment.