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 runny nose, cough, headache, difficulty swallowing, swollen lymph nodes, and a hoarse vo ...

(inflammation of the

pharynx The pharynx (: pharynges) is the part of the throat behind the human mouth, mouth and nasal cavity, and above the esophagus and trachea (the tubes going down to the stomach and the lungs respectively). It is found in vertebrates and invertebrates ...

) 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 in humans and other mammals, which can often be seen as flesh-colored, pinkish ...

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

fusiform Fusiform (from Latin ''fusus'' ‘spindle’) means having a spindle (textiles), spindle-like shape that is wide in the middle and tapers at both ends. It is similar to the lemon (geometry), lemon-shape, but often implies a focal broadening of a ...

(''

Fusobacterium ''Fusobacterium'' is a genus of obligate anaerobic, Gram-negative, non-sporeforming bacteria belonging to Gracilicutes. Individual cells are slender, rod-shaped bacilli with pointed ends. ''Fusobacterium'' was discovered in 1900 by Courmont an ...

'' spp.) and

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

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 ...

'' spp. 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 ...

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

Naming and confusion with Vincent's gingivitis

It is named after Jean Hyacinthe Vincent, a French physician who was working at the Paris

Pasteur Institute The Pasteur Institute (, ) 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 for anthrax and rabies. Th ...

. 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; ulitis is an alternative term. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms (also ...

". 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 Cell death, death of Cell (biology), cells in living Tissue (biology), tissue by Autolysis (biology), autolysis. The term "necrosis" came about in the mid-19th century and is c ...

(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, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium). It is most commonly a symptom of coronary artery disease. Angina is typically the result of parti ...

("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 In medicine, malaise is a feeling of general discomfort, uneasiness or lack of wellbeing and often the first sign of an infection or other disease. It is considered a vague termdescribing the state of simply not feeling well. The word has exist ...

(fatigue), *

Lymphadenopathy Lymphadenopathy or adenopathy is a disease of the lymph nodes, in which they are abnormal in size or consistency. Lymphadenopathy of an inflammatory type (the most common type) is lymphadenitis, producing swollen or enlarged lymph nodes. In c ...

(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 ...

), *

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. Th ...

(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 sloughin ...

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 biological tissue, 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 ...

Diagnosis

Differential diagnosis In healthcare, a differential diagnosis (DDx) is a method of analysis that distinguishes a particular disease or condition from others that present with similar clinical features. Differential diagnostic procedures are used by clinicians to di ...

is with follicular (lacunar) tonsillitis,

diphtheria Diphtheria is an infection caused by the bacteria, bacterium ''Corynebacterium diphtheriae''. Most infections are asymptomatic or have a mild Course (medicine), clinical course, but in some outbreaks, the mortality rate approaches 10%. Signs a ...

syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms depend on the stage it presents: primary, secondary, latent syphilis, latent or tertiary. The prim ...

and acute

leukemia Leukemia ( also spelled leukaemia; pronounced ) is a group of blood cancers that usually begin in the bone marrow and produce 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 being

immunocompromised Immunodeficiency, also known as immunocompromise, 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 affe ...

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

{{Reflist Tonsil disorders Pharynx Bacterial diseases