Angina, plaut-vincenti A69.1

Acute ulcerative tonsillitis due to mixed infection with Treponema vincenti (see spirochetes below), Fusobacterium plauti and other spirochetes, Bacteroides species.

Unilateral dysphagia, smeary tonsillar coating, crater-like ulcer at the upper tonsillar pole. Painful swelling of lymph nodes. Foetor ex ore. Response to penicillin is good.

Pathogens cannot be cultivated. Therefore microscopic detection (presence of rod bacteria and treponemes)

Penicillin V: Adults: 3 times/day 600,000 IU or 2 times/day 1 million IU p.o. for 7-10 days, in children 50,000-100,000 IU/kg bw/day.

Alternative: In penicillin allergy erythromycin (e.g. paediathrocin) 3-4 times/day 250-500 mg p.o. or i.v., children 20-50 mg/kg bw/day spread over 2-4 ED, clarithromycin (e.g. Klacid) 2 times/day 250-500 mg p.o., children 15 mg/kg bw/day spread over 2 ED, alternatively cephalosporins.

For relapse p.o. cephalosporin or clindamycin (e.g. Sobelin) 3-4 times 300 mg/day p.o., children 8-25 mg/kg bw/day p.o. in 4 EDs.

For severe pain, analgesics such as paracetamol (e.g. ben-u-ron Supp.) for children or acetylsalicylic acid (e.g. ASS) for adults.

With adequate therapy usually rapid healing. Spontaneous healing is also possible. Under immunosuppression, necrotizing inflammation that progresses beyond the organ boundaries and leaves severe destruction(N0ma).