Vincent's angina (also termed Plaut-Vincent's angina), is

pharyngitis Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a Rhinorrhea, runny nose, cough, headache, difficulty swallowing, swollen lymph nodes, and a ...

(inflammation of the

pharynx The pharynx (plural: pharynges) is the part of the throat behind the mouth and nasal cavity, and above the oesophagus and trachea (the tubes going down to the stomach and the lungs). It is found in vertebrates and invertebrates, though its st ...

) and

tonsillitis Tonsillitis is inflammation of the tonsils in the upper part of the throat. It can be acute or chronic. Acute tonsillitis typically has a rapid onset. Symptoms may include sore throat, fever, enlargement of the tonsils, trouble swallowing, and en ...

(inflammation of the

palatine tonsil Palatine tonsils, commonly called the tonsils and occasionally called the faucial tonsils, are tonsils located on the left and right sides at the back of the throat, which can often be seen as flesh-colored, pinkish lumps. Tonsils only present a ...

s), caused by infection with two types of bacteria called fusiform (''

Fusobacterium ''Fusobacterium'' is a genus of anaerobic, Gram-negative, non-sporeforming bacteria belonging to Gracilicutes. Individual cells are slender, rod-shaped bacilli with pointed ends. Strains of ''Fusobacterium'' cause several human diseases, includi ...

species'') and

spirochaete A spirochaete () or spirochete is a member of the phylum Spirochaetota (), (synonym Spirochaetes) which contains distinctive diderm (double-membrane) gram-negative bacteria, most of which have long, helically coiled (corkscrew-shaped or s ...

s (''

Borrelia ''Borrelia'' is a genus of bacteria of the spirochete phylum. Several species cause Lyme disease, also called Lyme borreliosis, a zoonotic, vector-borne disease transmitted by ticks. Other species of ''Borrelia'' cause relapsing fever, and are t ...

species'' and ''

Spirillum ''Spirillum'' is a genus of Gram-negative bacteria in the family '' Spirillaceae'' of the '' Nitrosomonadales'' of the ''Betaproteobacteria''.Garrity, George M.; Brenner, Don J.; Krieg, Noel R.; Staley, James T. (eds.) (2005). Bergey's Manual o ...

species''). This symbiosis of bacteria is sometimes termed a "fusospirochaetal" infection.

Naming and confusion with Vincent's gingivitis

It is named after

Jean Hyacinthe Vincent Jean Hyacinthe Henri Vincent (22 December 1862 – 23 November 1950) was a French physician who was a native of Bordeaux. He was an associate professor at Val-de-Grâce, as well as medical inspector general with the French Army. Later he attaine ...

, a French physician who was working at the Paris

Pasteur Institute The Pasteur Institute (french: Institut Pasteur) is a French non-profit private foundation dedicated to the study of biology, micro-organisms, diseases, and vaccines. It is named after Louis Pasteur, who invented pasteurization and vaccines ...

. Vincent described a fusospirochetal infection of the pharynx and palatine tonsils, causing "ulcero-membranous pharyngitis and tonsillitis", which later became known as Vincent's angina. Later in 1904, Vincent described the same pathogenic organisms in "ulceronecrotic

gingivitis Gingivitis is a non-destructive disease that causes inflammation of the gums. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms (also called plaque) that is attached ...

". As a result, Vincent's angina is widely confused with

necrotizing ulcerative gingivitis Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. Necrosis is caused by factors external to the cell or tissue, such as infection, or trauma which result in the unregulated dige ...

(previously also called "Vincent's gingivitis"), however the former is tonsillitis and pharyngitis, and the latter involves the gums, and usually the two conditions occur in isolation from each other. The term "angina" is derived from a Latin word which means "to choke" or " to throttle." However, this condition should not be confused with the modern usage of the term angina ("angina pectoris"), which refers to chest pain caused by insufficient blood supply to the muscles of the heart. Many publications using the term "Vincent's angina" date from the twentieth century, and the term is not so common in modern times.

Symptoms

Symptoms of Vincent's angina were reported as: * Normal or increased temperature * Headaches * Chilly sensations, * Generalized malaise (fatigue), * Lymphadenopathy (enlargement of submaxillary and cervical lymph glands), * Tenderness and severe pain when talking or swallowing (

odynophagia Odynophagia is pain when swallowing. The pain may be felt in the mouth or throat and can occur with or without difficulty swallowing. The pain may be described as an ache, burning sensation, or occasionally a stabbing pain that radiates to the b ...

), *

Halitosis Bad breath, also known as halitosis, is a symptom in which a noticeably unpleasant breath odour is present. It can result in anxiety among those affected. It is also associated with depression and symptoms of obsessive compulsive disorder. ...

(bad breath) If the gums are also involved, symptoms of necrotizing ulcerative gingivitis, such as painful gums may also be present. The tonsils show single or multiple greyish-white

ulcer An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...

s, usually on only one of the palatine tonsils. The ulcers appear surrounded by reddened area and they bleed when touched or when the pseudo membrane is removed. Ulceration may extend onto the

soft palate The soft palate (also known as the velum, palatal velum, or muscular palate) is, in mammals, the soft tissue constituting the back of the roof of the mouth. The soft palate is part of the palate of the mouth; the other part is the hard palate. ...

Diagnosis

Differential diagnosis is with follicular (lacunar) tonsillitis,

diphtheria Diphtheria is an infection caused by the bacterium '' Corynebacterium diphtheriae''. Most infections are asymptomatic or have a mild clinical course, but in some outbreaks more than 10% of those diagnosed with the disease may die. Signs and s ...

, syphilis and acute

leukemia Leukemia ( also spelled leukaemia and pronounced ) is a group of blood cancers that usually begin in the bone marrow and result in high numbers of abnormal blood cells. These blood cells are not fully developed and are called ''blasts'' or ...

. One of the risk factors for Vincent's angina is

immunocompromise Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that a ...

Alternative definitions

Different types of Vincent's angina were sometimes defined, such as pseudomembraneous,Progressive Medicine: A Quarterly Digest of Advances, Discoveries, and Improvements in the Medical and Surgical Sciences. (1927). United States: Lea & Febiger. or acute / subacute / chronic / recurrent.

References

{{improve categories, date=January 2023 Tonsil disorders