Angina Simanovsky-Plaut-Vincent

Angina Simanovsky-Plaut-Vincent, or ulcerative-necrotic angina, is caused by a spindle-shaped rod (V. Fusiformis) in symbiosis with the usual spirochaete of the oral cavity. (spirochacta buccalis).

The mass outbreak of ulcerative-retina angina was observed in Finland by SP Botkin in 1888. Later, according to the data of BS Preobrazhensky (1956), NP Botkin studied its epidemiology and in 1890 gave a detailed description of this disease. However, his pathogen remained unknown. In 1898 the French doctor K.Plaut and a little later his colleague H.Vensen discovered a characteristic causative agent of this disease.

Angina Simanovsky often appears in exhausted and weakened by previous diseases people suffering from hypovitaminosis, alimentary dystrophy, especially when there is a lack of protein and amino acids in food products. The disease arises sometimes sporadically, sometimes has an epidemic nature. In some cases, Simanovsky's angina is caused by the presence of carious teeth, paradontitis, gingivitis and other odontogenic causes that contribute to vegetation of the spindle-shaped rod.

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How manifested angina Simanovsky?

The general condition of the patient remains almost normal, the state of health is satisfactory. Often he seeks a doctor because of the appearance of an unpleasant, putrid smell from his mouth and drooling. In uncomplicated cases, body temperature, as a rule, normal or subfebrile, only sometimes the disease begins with a high temperature (38 ° C and above) and chills. Such a start is more typical for epidemic outbreaks. In the blood can be determined moderately pronounced leukocytosis. Subsequently, pain occurs when swallowing and an increase in regional lymph nodes, palpable in relation to the palatine tonsils and oropharyngeal region.

With pharyngoscopy, one of the amygdala lesions and accompanying stomatitis are most often detected. The tonsil is enlarged, hyperemic, covered with a yellowish-gray loose coating, which is easily removed. Under it, a slightly bleeding ulcer with a grayish-yellow bottom and uneven edges, soft to the touch, is found. Ulceration, in addition to the amygdala, can spread to the arches, and sometimes to other parts of the oropharynx, the mucous membrane of the cheeks and gums. In uncomplicated course, the duration of the disease does not exceed 2-3 weeks. In typical cases of Siminsky's angina, there is a disproportion between pronounced destructive changes in the pharynx (raids, ulcers, necrosis) and a relatively mild general condition of the patient. Acceding sometimes coccal infection dramatically changes the overall clinical picture: there is a strong pain when swallowing, body temperature increases significantly, chills may appear. Patients with severe forms of the disease must be hospitalized.

Complications of Simanovsky's angina are rare, but if they occur, they are severe with extensive necrotic destruction in the mouth and throat (hard palate perforation, gum destruction, extensive tonsil necrosis, etc.) that can cause arthrosis bleeding.

How is angina Symanovski diagnosed?

The diagnosis of angina Simanovsky is established on the basis of the clinical picture and the results of a bacteriological study in which a large number of spindle-shaped sticks and spirochaetes of the oral cavity are found in remote raids or scrapings from the bottom of the ulcer. It should, however, be taken into account that fusospirochetny symbiosis is sometimes found in other diseases of the pharynx, for example, with ulcerated cancer. Differentiated angina of Simanovsky with diphtheria of pharynx, syphilis, tuberculosis and malignant malignant tumor of the amygdala.

How is angina treated Simanovsky?

Treatment consists of rinsing the mouth with solutions of hydrogen peroxide, potassium permanganate, dusting the ulcer surface with powder of wasarsol. In the absence of effect, penicillin and nicotinic acid are prescribed.