Picture of Vincent's Angina of the Tonsil (Trench Mouth)
This page was last updated: April 21, 2020

Vincent's Angina is an acute necrotizing infection of the pharynx caused by a combination of fusiform bacilli (Fusiformis fusiformis - a Gram -ve bacillus) and spirochetes (Borrelia vincentii ). These are the same organisms that cause a gingivostomatitis known as trench mouth.

The patient complains of unilateral sore throat that increases in intensity over several days with an associated referred earache on the same side. In addition, the patient complains of a bad taste in the mouth and a fetid bad breath. 

On examination, there is a deep well circumscribed unilateral ulcer of one tonsil. The base of the ulcer is gray and bleeds easily when scraped with a swab.  There may also be an associated submandibular lymphadenopathy.

Vincent angina is diagnosed using a gentian violet-stained smear of the pharyngeal exudate, which demonstrates the presence of Fusobacterium and spirochetes.

Penicillin or Clindamycin  and surgical debridement are the recommended treatment.

Vincent's Angina of the Left Tonsil. The ulcer is friable and bleeds easily when swabbed.

Bechara Y. Ghorayeb, MD
Otolaryngology - Head & Neck Surgery

Memorial Hermann Professional Building
1140 Business Center Drive, Suite  560
Houston, Texas 77043
For appointments, call: 713 464 2614