Vincent’s Angina

A 29-year-old male patient presented to our hospital with a several-day history of right-sided odynophagia and cervical lymph node swelling. The patient did not have fever. Clinical examination showed an ulcer in the region of the right tonsil (figure 1). A swab revealed the presence of infection by Treponema vincenti and Fusobacterium nucleatum consistent with Vincent’s angina. Penicillin therapy was initiated, under which symptoms completely resolved. Vincent’s angina (Angina ulceromembranacea) is a form of what is generally unilateral tonsillitis due to a mixed infection by spirochetes and fusobacteria that manifests as a one-sided sore throat and difficulty swallowing. From a clinical perspective, one sees a fibrin-covered ulceration of the tonsil. The diagnosis is confirmed by swab testing. The treatment of choice is antibiotic therapy with penicillin. Findings should always be clinically followed-up. If the ulcer fails to heal, a histological investigation is indicated since tonsillar carcinoma needs to be considered from a differential diagnostic point of view.

Figure 1.

Translated from the original German by Christine Rye.

Cite this as: Wiegand S, Dietz A: Vincent’s angina.