This is trench mouth, a progressive painful infection with ulceration, swelling and sloughing off of dead tissue from the mouth and throat due to the spread of infection from the gums.

• Ulcer surface covered with grey pseudomembrane surrounded by erythema.
• Fever, gingival bleeding, lymphadenopathy.


-Metronidazole 400 mg tds × 5 days.
-Cap Becosule 1 daily.
-Alkaline mouth wash.

In early acute necrotizing ulcerative gingivitis(Vincent’s infection), treatment with oral penicillin V 500 mg q6h and metronidazole 400 mg q8h is usually sufficient.

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