Vincent's angina is an ulcerative membranous inflammation caused by the combined action of anaerobic fusiform bacilli and spirochetes. Although these pathogens exist in the oral cavity of healthy individuals, they do not cause disease. The condition only occurs when the body's resistance is compromised, such as due to excessive fatigue, malnutrition, vitamin deficiency, gastrointestinal disorders, drug poisoning, or poor oral hygiene.

bubble_chart Clinical Manifestations

Sore throat is the main symptom, as the lesion initially occurs on one side of the tonsil or gums, so early-stage pain is often unilateral. Patients often experience fetid mouth odor, difficulty swallowing, headache, general malaise, back and arthralgia, with body temperature generally not exceeding 38.5°C. Systemic symptoms are milder than those of acute tonsillitis.

Examination reveals ulcers on the tonsils covered with a pseudomembrane, surrounded by hyperemic tissue. In severe cases, the lesion may spread to the entire pharynx or oral cavity. Smears may reveal fusiform bacilli and spirochetes. The pseudomembrane in this condition is formed by necrotic material from the ulcer and can be easily wiped away, leaving small bleeding points on the ulcer surface. Enlargement and tenderness of the ipsilateral submandibular lymph nodes may appear early in the course of the disease.

bubble_chart Diagnosis

Based on clinical symptoms and pharyngeal examination, the diagnosis can be confirmed if fusiform bacilli and Vincent's spirochetes are found in the throat swab smear. It should be differentiated from acute lacunar tonsillitis, pharyngeal diphtheria, and hematologic angina.

The prognosis of this disease is good, and penicillin treatment is effective. Locally, compound formula borax solution, 1% hydrogen peroxide, or 1:5000 potassium permanganate solution can be used for gargling. Alternatively, after removing the pseudomembrane from the ulcer surface, cauterize the ulcer with 10% silver nitrate to promote healing. The disease is contagious, so isolation precautions are necessary. Concurrent treatment of the primary condition is essential. If ulcerative membranous inflammation of the tonsils recurs repeatedly, a tonsillectomy should be performed at an appropriate time.