[Paul-Vincent infection as a pathogenetic concept].
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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.
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The cases of two patients with acute necrotizing ulcerative infections are reported. One had involvement of the tonsil and the other, of the gingivae. In both cases a Gram stain revealed abundant fusiform rods and spirochetes. Both patients responded to treatment with oral penicillin, showing improvement and/or healing in three to six days. These two cases demonstrate the usefulness of the Gram stain in supporting a diagnosis which would otherwise rest solely on clinical grounds.
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