-IBIS-1.5.0-
tx
eyes/ears/nose/throat
necrotizing gingivitis
diagnoses
definition and etiology
definition: An acute infection beginning on the interdental papillae then spreading to the margin and attached gingiva. Also called "Trench Mouth", "Vincent's Angina", "Acute Necrotizing Ulcerative Gingivitis", "Fusospirochetosis", "Vincent's Stomatitis".
etiology: The associated organisms are a fusiform bacillus and a spirochete. Factors involved in the development of the disease include: poor oral hygiene; malnutrition or poor eating habits; heavy smoking; lack of rest; marked physical or emotional stress; blood dyscrasias; or severe illnesses. The disease is most often seen in young adults.
signs and symptoms
The onset is usually sudden:
Malaise.
Offensive breath.
Painful, bleeding gums.
Salivation.
Bad taste in mouth.
Fever is usually absent unless a secondary infection has set in.
Ulcerations: punched-out lesions on gumline, covered by a gray membrane; they bleed easily.
HEENT lymphadenopathy is often present.
Dysphagia and pain on talking.
lab findings:
high numbers of fusospirochetes on stain of oral scrapings
course and prognosis
With gentle treatment: and addressing the initiating factors: the prognosis is excellent. It is suggested that antibiotics only be used if the patient has a high fever; otherwise, rest, gentle debridement of the involved areas, oral hygiene, proper nutrition, and good fluid intake are all that is needed. If left untreated and the condition worsens there may be spread to the buccal mucosa, teeth, and the maxilla and/or mandible with the possibility of severe tissue and bone loss.
differential diagnosis
Primary herpes simplex outbreak.
Streptococcal or staphylococcal pharyngitis.
footnotes