Vincent's disease


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acute necrotising ulcerative gingivitis

A condition characterised by progressive necrosis of intraoral tissues and upper respiratory abscesses, which is seen in those with poor oral hygiene and suboptimal nutrition, often linked to herpes simplex and anaerobic flora—e.g., Fusobacterium spp, spirochetes.

Acute necrotizing ulcerative gingivitis (ANUG) appears to be the most appropriate for a polymicrobial (‘fusospirochetal’) gingival infection that most commonly occurs in a back-group of malnutrition, stress and poor oral hygiene; with time the ulcerating or ulceromembranous lesions may spread to the rest of the oral cavity.

It is also a more accurate term for the antiquated Vincent's angina, in which the infection is seated on the soft palate and tonsils.

The microbiological analysis of the lesions of ANUG, given that certain bacteria may cause acute (eg Streptococcus spp) and/or ulceromembranous (eg Corynebacterium diphtheriae) lesions.

“Trench mouth” is a coinage of World War I vintage which attributed ANUG to living in close quarters—i.e., “the trenches”.

Clinical findings
Pain, oedema, punched-out ulcers, pseudomembrane formation, halitosis.

DiffDx
Erythema multiforme, lichen planus, pemphigus, bullous pemphigoid.
 
Management
H2O2, antibiotics (e.g., tetracycline, if fever or lymphadenopathy), saline mouth rinse, local anaesthetics.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

Vincent's disease

Painful inflammation of the mouth caused by two organisms, Bacillus fusiformis and Borrelia vincenti . These are commonly present in the mouth and cause infection only if some other factor, such as immune deficiency or vitamin B deficiency, operates. Vincent's disease features painful ulcers and an acute destructive inflammation of the gums called necrotizing gingivitis. It is treated with the antibacterial drug metronidazole, an antiseptic mouthwash and dental scaling to remove calculus. Also known as trench mouth. (Jean-Hyacinthe Vincent, 1862–1950, French bacteriologist).
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005