Angina, plaut-vincenti A69.1

Acute ulcerative tonsillitis due to mixed infection with Treponema vincenti (see spirochetes below), Fusobacterium plauti and other spirochetes, Bacteroides species.

Mostly children and young people.

Unilateral dysphagia, smeary tonsillar coating, crater-like ulcer at the upper tonsillar pole. Painful swelling of lymph nodes. Foetor ex ore. Response to penicillin is good.

Pathogens cannot be cultivated. Therefore microscopic detection (presence of rod bacteria and treponemes)

Diphtheria, syphilitic primary effect, angina lacunaris.

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 ).

Penicillin V: Adults: 600,000 IU 3 times daily or 1 million IU 2 times daily, taken by mouth for 7–10 days; for children, 50,000–100,000 IU/kg body weight per day.

Alternatively: In case of penicillin allergy, erythromycin (e.g., Paediathrocin) 250–500 mg orally or intravenously 3–4 times daily; for children, 20–50 mg/kg body weight per day divided into 2–4 doses; clarithromycin (e.g., Klacid) 2 times daily, 250–500 mg orally; for children, 15 mg/kg body weight per day divided into 2 doses; alternatively, cephalosporins.

In case of recurrence, administer a cephalosporin or clindamycin (e.g., Sobelin) orally 300 mg 3–4 times daily; children: 8–25 mg/kg body weight per day, divided into 4 doses.

For severe pain, use analgesics such as acetaminophen (e.g., ben-u-ron suppositories) for children or acetylsalicylic acid (e.g., ASS) for adults.

With appropriate treatment, healing is usually rapid. Spontaneous healing is also possible. Under immunosuppression, necrotizing inflammation occurs that spreads beyond the boundaries of the organ and causes severe destruction (see alsoNoma).