RT Book, Section A1 Raffanti, Stephen P. A1 Person, Anna K. A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181057497 T1 Acute Necrotizing Ulcerative Gingivitis T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181057497 RD 2024/03/29 AB Acute necrotizing ulcerative gingivitis (ANUG), also known as Vincent angina or trench mouth, is commonly seen in HIV-infected patients. It is a distinct and rapidly progressive ulceration typically starting at the tip of the interdental papilla, spreading along the gingival margins, eventually destroying the periodontal tissue. The triad associated with ANUG is oral pain, halitosis, and ulcerations. Other signs and symptoms include “metallic taste,” “wooden teeth” sensation, tooth mobility, fever, adenopathy, and malnutrition. The cause of this aggressive, destructive process in HIV patients is a polymicrobial infection by oral anaerobes (Treponema, Selenomonas, Fusobacterium, Porphyromonas, Prevotella). ANUG represents a spectrum of disease from mild ulcerations to severe cellulitis and spread of the infection to the soft tissues, cheeks, lips, and bones.