Gebhardt B, Herrmann K, Roessner A, Vorwerk U
Medizinische Fakultät, Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Magdeburg.
Laryngorhinootologie. 2010 May;89(5):266-9. doi: 10.1055/s-0029-1243192. Epub 2010 May 10.
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 inflammations in the oropharynx differential-diagnostically important to consider also the anaerobic type Prevotella, especially Prevotella disiens as a potential trigger .
Because the clinical course forms of a necrotisising oropharyngeal inflammations can be very different and complicate so a suitable diagnosis, it is very important to get a complete and perfect cause proof. For getting this proof a correct test production, transport and cultivation are of extreme importance .
The type Prevotella consists of different species gram-negative, obligate anaerobic strains. They are regarded as a cause of suppurating inflammations and abscesses of the genital tract and are components of the aerobic anaerobic mixed flora in case of gingival infections. The sole proof in the microbiological culture as a smear test result of a one-sided necrotisising tonsillitis has to be seen as a first description by reason of missing literature .
As triggers for one-sided necrotisising tonsillitis are considered different causes. Next a carcinoma of the tonsil, Lues, Angina Plaut-Vincent have to be excluded. An infection with Prevotella disiens is an extremely rare variation in contrast. However, the transmission is possible by insufficient hygiene, lack phenomena and sexual intercourse and to consider therefore as an exclusion diagnosis.
单侧坏死性感染性扁桃体炎最广为人知的临床症状是普劳特和文森特(1894年)所描述的普劳特-文森特咽峡炎。除了这种梭形螺旋体病外,在口咽坏死性炎症的鉴别诊断中,还必须考虑厌氧型普雷沃菌,尤其是解脲普雷沃菌作为潜在病因。
由于坏死性口咽炎症的临床病程形式可能非常不同,从而使诊断复杂化,因此获得完整准确的病因证据非常重要。为了获得这一证据,正确的样本采集、运输和培养至关重要。
普雷沃菌属由不同种类的革兰氏阴性专性厌氧菌株组成。它们被认为是生殖道化脓性炎症和脓肿的病因,也是牙龈感染时需氧厌氧混合菌群的组成部分。鉴于缺乏相关文献,单侧坏死性扁桃体炎的微生物培养涂片检查结果作为唯一证据应被视为首次描述。
单侧坏死性扁桃体炎的病因有多种。接下来必须排除扁桃体癌、梅毒、普劳特-文森特咽峡炎。相比之下,解脲普雷沃菌感染是一种极为罕见的情况。然而,其可通过卫生条件差、局部现象及性行为传播,因此应考虑为排除性诊断。