Artikel
Prevotella disiens – cause of an unilateral necrotic tonsillitis
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Veröffentlicht: | 22. Juli 2009 |
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Gliederung
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The species Prevotella is an anaerobic gramnegative rodshaped bacterium.
Prevotella is a normal part of the human flora. According to its enzyme profile it is possible to classify different subspecies.
Corresponding to their local position on the human mucosa they are main organisms for different infections: Prevotella disiens (pelvic and genital infections), Prevotella bivia (pelvic and genital infections), Prevotella melaninogenica (oropharyngeal infections), Prevotella intermedia (oropharyngeal infections).
A therapy with Clindamycin, Amoxicillin or Metronidazol is state of the art.
Casuistry: A 30 years old woman turned to our ambulance. She complained about Odynodysphagia, Foetor ex ore and a painful left Lymphadenitis colli.
The oropharyngeal inspection showed a fibrinous necrotic ulcus in the left Regio tonsillaris.
The therapy occurred by medication with Augmentan and a bilateral tonsillectomy. The microbiological analysis yielded large quantities of Prevotella disiens at the anaerobic culture and the normal flora of the oropharynx at the aerobic culture.
This constellation of a Prevotella disiens infection is the first case reported in literature.
The histopathology was a chronic-fibrotic and unspecific tonsillitis.
Conclusion: The most cases of unilateral necrotic tonsillitis are: carcinoma at the tonsil, Lues, Angina Plaut-Vincent and Agranulocytosis.
A Prevotella disiens infection is a rarity – but the transmission of Prevotella disiens is possible by intercourse or as a result of a lack of hygiene.