The Angina Plaut-Vincenti refers to the relatively rare subspecies of tonsillitis, for which a mixed infection of the bacteria Treponema vincentii and Fusobacterium nucleatum is responsible. The tonsillitis is typically one-sided, mostly juveniles are affected.

What is Angina Plaut-Vincenti?

Although the angina plaut-Vincenti is a severe almond infection, in addition to dysphagia there are hardly any noticeable complaints.
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Tonsillitis is often painful, but usually harmless diseases that affect mainly children and adolescents and are often treated due to the risk of complications or sequelae with antibiotics.

The medicine subdivides these illnesses, which often look similar to the layman, to the different types of pathogens or assign them to larger diseases. Angina Plaut-Vincenti is a relatively rare subset of tonsillitis (tonsillitis).

causes

The angina Plaut-Vincenti owes its less catchy name, as so often in medicine, to its discoverers: As early as 1894, the German bacteriologist HC Plaut described the bacterium Treponema vincentii, which belongs to the spirochete class, and gave it its name. A little later, the disease was further specified by the French scientist JH Vincent.

A peculiarity of these bacteria is that they do not simply migrate from one person to another by contagion, as is the case, for example, with the most common form of tonsillitis caused by streptococci. On the contrary, they can also live on the human mucous membranes without causing any damage - only the combination of both bacteria (coinfection) ensures that they become pathogenic, they need each other for their pathogenic effects.

In addition, the bacteria usually need favorable conditions: Inadequate oral hygiene, a poor nutritional status or a generally weakened immune system of the organism can prepare the soil for them. Angina Plaut-Vincenti is also referred to as Tonsillitis ulcerosa, as its clinical picture is characterized by ulcerated (ulcerous) almonds, which are accompanied by necrosis (tissue descent). This can spread in the course of the surrounding oral cavity.

Symptoms, complaints & signs

Although the angina plaut-Vincenti is a severe almond infection, in addition to dysphagia there are hardly any noticeable complaints. The general condition is usually not impaired. The body temperature is only slightly elevated. It is usually between 36 and 37 degrees Celsius.

On closer examination, however, a unilateral ulcer on a palatine almond can be detected, which leads to the death of the mucous membrane. This gives greasy green-gray-yellowish deposits that cause a foul-smelling bad breath. The ulcers already differ from the appearance of a normal tonsillitis. It is a special form of angina tonsillitis.

While normal tonsillitis is caused by streptococci, there is a mixed infection between spirochaetes and fusobacteria. These can also infect the cheeks, the gums, the lips and the larynx in addition to the almonds. The lymph nodes present in the jaw angle are almost always swollen. Especially adolescents often become infected with these pathogens.

Fusobacteria and spirochetes, however, are very aggressive bacteria that can lead to the destruction of the cheeks and gums, especially in immunocompromised individuals. Thus, in various developing countries, where the population suffers from malnutrition and hunger, this dissection often results in disfigurement of the face due to necrosis of the cheeks. In exceptional cases, an Angina Plaut-Vincenti but also lead here to a gangrenous destruction of the cheeks.

Diagnosis & History

Another important difference between the Angina Plaut-Vincenti and the other, more common forms of tonsillitis is the one-sided occurrence: Normally, only one palatine tonsil is affected, but this massive: One sees on inspection of the oral cavity a fibrinbedecktes ulcer with necroses, also falls a gray - Greenish greasy surface of the affected almond, which can bleed when stripping with the wooden spatula. The inflammation secretes a foul-foul smell.

In contrast, the streptococcal angina usually affects both palate tonsils and looks completely different with their typical white stippchenhaft coverings in the reason - a gaze diagnosis.

The symptoms of Angina Plaut-Vincenti are usually one-sided, but are strikingly different as far as their expression is concerned: The disease looks bad, but does not cause general complaints, often no fever, only one-sided dysphagia and fall in addition to the visible findings and the foul odor usually for a doctor's visit.

complications

The Angina Plaut-Vincenti usually runs in modern industrialized countries without serious complications. However, with poor oral hygiene, the tissue necroses can spread from the tonsils to the entire oral cavity. There is a risk of tooth loss and destruction of gum tissue.

In developing countries, the clinical picture can develop much more dramatically. In weakened and malnourished people or people who suffer from immunodeficiency, the Angina Plaut-Vincenti is often chronic. As the necroses lead to anaerobic conditions in the tissues, can occur as consequences, inter alia, intestinal ulcer, ulcer, and pulmonary gangrene.

A dreaded complication is gangrenous stomatitis, which is also called noma, cheek blight or water cancer. Due to the often poor medical care in the affected countries, the disease is progressing steadily. Starting from the oral mucosa, the bacteria of the oral flora destroy the mucous membrane, the bones and the face over time.

Left untreated, the general condition worsens dramatically and life-threatening complications occur. These include bloody diarrhea, pneumonia and sepsis. In 70 to 90 percent of cases, the affected children die as a result.

When should you go to the doctor?

The symptoms of tonsillitis should go to the doctor no later than the next day. The doctor can determine by a throat swab and the examination of the oral cavity, if it is an Angina Plaut-Vincent and cause appropriate treatment steps. A typical warning sign for an angina Plaut-Vincent is foul-smelling greenish-gray plaque in the pharynx. The discharge is often accompanied by dysphagia, halitosis and the typical symptoms of tonsillitis.

Later, an ulcer may also form on the palatine tonsils. If the above-mentioned guidelines are present, medical advice is required. An immediate visit to a doctor is recommended if a high fever over 39 ° C is added. If children are affected, they should be taken to the pediatrician immediately.

Medical advice is especially needed for severe physical symptoms that increase rapidly despite the use of home remedies and light medicines. An advanced Angina Plaut-Vincent must be treated in any case. As a result, complications such as tissue necrosis, tooth loss and spread of inflammation can be avoided.

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Treatment & Therapy

Since other, serious illnesses can be behind such a picture of tonsillitis, the doctor's visit is worth in two ways.

In particular, malignant oropharyngeal tumors may look similar, but tend to grow more slowly and typically affect other age groups (Angina Plaut-Vincenti: adolescents; oral cavity tumors: smokers from middle age). Also diseases such as tuberculosis or other treponematosis, syphilis, must be considered in principle. Furthermore, chronic tonsillitis caused by other bacterial pathogens can lead to greater destruction of the affected tonsil, but then has a correspondingly longer history.

If the inflammation develops within a short time and without further general complaints such as coughing, nocturnal sweating or weight loss, simple angina is the most likely diagnosis. An experienced doctor can assess this with a few questions and a glance, in case of doubt, a microbiological examination after smear of the affected almond, rarely a blood test, can provide clarity.

In principle, however, the differentiation from streptococcal angina is a visual diagnosis, and Angina Plaut-Vincenti can then be treated without much ado: antibiotic therapy is only really necessary in more severe cases and is then carried out with penicillins, for example. Otherwise, sufficient disinfecting local measures and careful oral hygiene.

Outlook & Forecast

In Angina Plaut-Vincenti, the patient primarily experiences very heavy dysphagia and pain in the neck. These can significantly affect the quality of life and lead to complaints and complications in everyday life. Furthermore, tonsillitis occurs and those affected in many cases also suffer from a very strong halitosis.

Due to the difficulty swallowing, the ingestion of food and fluid is much more difficult, so that it may come to a dehydration or malnutrition. Furthermore, those affected are beaten and tired and usually can not concentrate anymore. Coughing or sweating often occurs, especially at night.

The treatment of Angina Plaut-Vincenti can be done with the help of medication and does not lead to further complications or complaints. As a rule, a positive course of the disease always occurs when a doctor is visited early. Special consequential damage does not occur. The life expectancy of the patient is not reduced by the Angina Plaut-Vincenti. After the treatment, however, a renewed illness is not excluded. This is especially true when the person suffering from a weakened immune system.

prevention

Also for prevention, the latter measures are the best means, especially if the organism is already weakened by other diseases or drug intake already immunosuppressed.

aftercare

With the Angina Plaut-Vincenti in most cases no follow-up care is necessary or possible. First and foremost, patients need medical treatment to completely alleviate the symptoms of Angina Plaut-Vincenti and prevent further complications. The disease can be cured well in most cases, so it does not come to a reduced life expectancy of the patient.

Patients are primarily dependent on the use of medication for this disease. Only then can the bacteria be killed. It is important to ensure a regular intake of antibiotics. Also possible interactions with other drugs should be considered in the Angina Plaut-Vincenti.

Patients should not consume alcohol during the treatment in order not to reduce the effect of the antibiotics. Regular blood tests also make sense in order to give an overview of the state of healing. Furthermore, attention must be paid to a high standard of hygiene, whereby above all the oral hygiene is to be considered. Staying at the hospital is not necessary at Angina Plaut-Vincenti.

You can do that yourself

This particular form of tonsillitis usually occurs when the bacteria that cause it find favorable conditions in the host. In particular, bad oral hygiene, poor nutrition and a weakened immune system can promote the outbreak of Angina Plaut-Vincenti and complicate their course. Self-help measures should therefore be aimed at eliminating these factors.

Good dental hygiene not only reduces the risk of contracting Angina Plaut-Vincenti, it also reduces the risk of tooth decay and periodontal disease. Everyone should therefore know and take note of the basic principles of oral hygiene. The teeth must be thoroughly cleaned at least twice a day. To do this, it has to be cleaned for about three minutes from red to white, ie from the gums to the teeth. The tongue, on which deposits and bacteria accumulate, must not be forgotten.

A healthy diet additionally supports oral hygiene. This also has a positive effect on the immune system, so that an Angina Plaut-Vincenti is doubly prevented. A healthy diet is based on whole grain cereals, nuts and seeds and as much fresh fruit and vegetables as possible. Animal fats and proteins should be reduced and replaced with plant-based products.

Furthermore, it is important to ensure sufficient exercise, with the health already benefits from a quick walk of about 30 minutes per day.

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