A 30 years old male reported with chief complaint of constant radiating, gnawing pain that is intensified by eating spicy foods and chewing. He also reported a “metallic” foul taste and an excessive amount of “pasty”saliva. A general examination revealed fever and increased pulse rate. Intra-oral examination showed punched-out, crater like depressions at the crest of the interdental gingival papillae, covered by a gray pseudomembranous slough, in the upper anterior teeth.
The most likely infection is
A 30 years old male reported with chief complaint of constant radiating, gnawing pain that is intensified by eating spicy foods and chewing. He also reported a “metallic” foul taste and an excessive amount of “pasty”saliva. A general examination revealed fever and increased pulse rate. Intra-oral examination showed punched-out, crater like depressions at the crest of the interdental gingival papillae, covered by a gray pseudomembranous slough, in the upper anterior teeth.
The most likely infection is
π‘ Explanation
**Core Concept**
The patient's symptoms and clinical findings are indicative of a specific type of oral infection characterized by necrotic tissue, foul odor, and a distinctive appearance of the gingival papillae.
**Why the Correct Answer is Right**
The patient's presentation is consistent with Vincent's angina, also known as trench mouth or acute necrotizing ulcerative gingivitis (ANUG). This condition is caused by a mixture of bacterial and viral pathogens, including fusiform bacteria and spirochetes, which lead to necrosis of the gingival tissue and the formation of the characteristic punched-out lesions. The presence of a gray pseudomembranous slough and the patient's symptoms, such as a foul taste and excessive saliva, further support this diagnosis. The disease is often associated with stress, poor oral hygiene, and malnutrition.
**Why Each Wrong Option is Incorrect**
* **Option A:** While gingivitis can cause inflammation and redness of the gingiva, it does not typically present with the severe necrosis and characteristic lesions seen in Vincent's angina.
* **Option B:** Periodontitis is a chronic infection of the periodontal tissues, which can cause pain and inflammation, but it does not typically present with the acute symptoms and characteristic lesions of Vincent's angina.
* **Option C:** Herpes simplex virus can cause oral ulcers, but the presentation and clinical findings in this case are more consistent with a bacterial infection, such as Vincent's angina.
**Clinical Pearl / High-Yield Fact**
Vincent's angina is often associated with poor oral hygiene, stress, and malnutrition. It is essential to investigate and address these underlying factors to prevent recurrence and promote healing.
**Correct Answer:** C.
β Correct Answer: A. Necrotizing ulcerative gingivitis
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