Angina, plaut-vincenti A69.1

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

angina ulceromembranacea; Borrelia vincenti; Fusospirochetosis; ulcerative angina

Definition
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Acute ulcerative tonsillitis caused by mixed infection with Borrelia vincenti, Fusobacterium plauti and other spirochetes, bacteroid species.

Manifestation
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Mostly children and young people.

Clinical features
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Unilateral difficulty in swallowing, greasy tonsil coating, crater-shaped ulcer at the upper pole of the tonsil. Painful swelling of the lymph nodes. Foetor ex ore.

Differential diagnosis
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External therapy
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Antiseptic mouth rinses with chlorhexidine gargle solution(e.g. Chlorhexidine gluconate solution, R045 ), tormentil astringent (e.g. Repha-OS Mouth Spray S, R255 ) or dexpanthenol solution(e.g. Bepanthen, R066 ).

Internal therapy
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  • Penicillin V: Adults: 3 times/day 600,000 IU or 2 times/day 1 million IU p.o. over 7-10 days, for children 50,000-100,000 IU/kg bw/day
  • Alternative: In case of penicillin allergy erythromycin (e.g. paediathrocin) 3-4 times/day 250-500 mg p.o. or i.v., children 20-50 mg/kg bw/day distributed on 2-4 ED, clarithromycin (e.g. Klacid) 2 times/day 250-500 mg p.o., children 15 mg/kg bw/day distributed on 2 ED, alternatively cephalosporins.
  • In case of recurrence p.o. cephalosporin or clindamycin (e.g. sobelin) 3-4 times 300 mg/day p.o., children 8-25 mg/kg bw/day p.o. divided into 4 ED.
  • For severe pain analgesics like paracetamol (e.g. ben-u-ron Supp.) for children or acetylsalicylic acid (e.g. ASS) for adults.

Progression/forecast
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With adequate therapy, usually rapid healing.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020