Cancrum Oris (Noma) with associated notes.pptx

Notes

1. Cancrum Oris ( Noma ) Dr Turinawe Jussy , MBCHB-MUK

2. Definition Cancrum oris , also known as noma /gangrenous stomatitis, is a severe, rapidly progressing gangrenous infection affecting the soft tissues of the mouth and face. It primarily affects malnourished children in impoverished regions and can cause extensive tissue destruction.

3. Causes -Malnutrition
-Poor oral hygiene
-Weakened immune system (e.g., due to HIV/AIDS or other chronic diseases)
-Recent illness (e.g., measles or malaria)
-Poor sanitation and living conditions
-The infection usually begins with gingivitis and involves anaerobic and aerobic bacteria, including Fusobacterium necrophorum , Prevotella , and Bacteroides species.

4. Clinical presentation -Starts with acute necrotizing ulcerative gingivitis (painful gums and ulcers)
-Rapid progression to tissue necrosis, affecting lips, cheeks, and jaw
-Foul-smelling discharge
-Facial swelling, pain, and possible fever
-Difficulty eating, speaking, and swallowing

5. Diagnosis 1. Clinical Examination: Characteristic gangrene and tissue destruction in the oral and facial regions.
2. Microbiological Testing: Culture of affected tissue, if possible, to identify causative organisms.
3. Blood Tests: May reveal anemia, malnutrition markers, and infection.

6. Treatment -Antibiotics: Broad-spectrum antibiotics to target anaerobic and aerobic bacteria.
-Nutritional Support: High-calorie diet, vitamins, and protein supplements to address malnutrition.
-Wound Care and Debridement: Removal of necrotic tissue to prevent the spread.
-Reconstructive Surgery: Often needed to repair facial deformities after infection control.
-Supportive Care: Pain management, hydration, and supportive therapy.

7. Complications Extensive facial disfigurement and scarring Difficulty with speech and eating Psychological and social stigma Increased risk of mortality, particularly in children if left untreated