Nekrotisierende Schleimhautulzera durch Anaerobier

Abstract

Vincent's angina (Plaut-Vincent) is the most prominent disease caused by coinciding infections from fusibacteria and spirochaeta both belonging to obligate anaerobic bacteria. A possible symbiotic infection of both anaerobics may become manifest on the mucous membranes of the oral cavity and the oropharynx beside the tonsillas. The clinical outcome may be different and pose difficulties in the differential diagnosis. We report the case of a 29 year old female patient with necrotizing ulcera of the soft palate suspicious for stomatitis ulceromembranacea. In case necrotizing inflammations of the oral cavity area were to be found infections due to anaerobic bacteria should be considered mostly occurring as mixed infections. The correct identification by cultivation turns out to be difficult in that it requires special conditions. Furthermore, reliable detection of these bacteria necessitates careful collection and transport of patients specimens. In case of Fusospirochaetosis (Fusotreponematose) a specimen should be prepared for microscopic examination beside setting up a special culture. This is because the staining is the most suitable procedure for bacteril identification to support the clinical diagnosis of stomatitis ulceromembranacea.

Differenzialdiagnostik der nekrotisierenden Tonsillitis

“…Neben der Angina Plaut-Vincent als h ä ufi gste Ursache f ü r eine infekti ö se, einseitig nekrotisierende Tonsillitis ,welche durch eine anaerobe Mischinfektion von Treponema vincentii und Fusobacterium nucleatum ausgel ö st wird, spielen auch andere Erreger aus dem anaeroben Spektrum, insbesondere die Gattung Prevotella, eine diff erenzialdiagnostisch wichtige Rolle bei entsprechenden oropharyngealen Infektionsprozessen [4,6,10] .…”

“…Background: The best known clinical picture of a one-sided necrotisising, infectious tonsillitis is the by Plaut and Vincent (1894) described angina Plaut-Vincent. In addition to this fusospirochetosis it is in case of necrotisising infl ammations in the oropharynx diff erential-diagnostically important to consider also the anaerobic type Prevotella, especially Prevotella disiens as a potential trigger [4,6,10] . Material and methods: Because the clinical course forms of a necrotisising oropharyngeal infl ammations can be very diff erent and complicate so a suitable diagnosis, it is very important to get a complete and perfect cause proof.…”