Cancrum oris

Cancrum oris, also known as Noma, is a rapidly progressive, often gangrenous infection of the mouth or face. It is associated with high morbidity and mortality and primarily affects malnourished children in low-income regions.

Etiology

The exact cause of cancrum oris is unknown, but it is often associated with conditions of extreme poverty, malnutrition, poor oral hygiene, and a weakened immune system. The bacterium Fusobacterium necrophorum is commonly found in lesions, suggesting a possible role in the disease's development.

Clinical Presentation

Cancrum oris typically begins as a small ulcer in the mouth, which rapidly progresses to significant tissue destruction. Symptoms may include pain, swelling, and foul-smelling discharge. In severe cases, the disease can lead to extensive destruction of the oral and facial tissues, causing disfigurement and functional impairment.

Diagnosis

Diagnosis of cancrum oris is primarily based on clinical presentation. Laboratory tests may be used to identify associated bacterial infections. Imaging studies, such as CT scans, may be used to assess the extent of tissue damage.

Treatment

Treatment of cancrum oris involves managing the underlying conditions, such as malnutrition and infections, and providing supportive care. Surgical debridement or reconstruction may be necessary in cases of extensive tissue damage. Antibiotics, such as metronidazole, are commonly used to treat associated bacterial infections.

Prognosis

The prognosis of cancrum oris is generally poor due to the rapid progression of the disease and the often-late presentation of patients. However, with early diagnosis and appropriate treatment, the prognosis can be significantly improved.

Prevention

Prevention strategies for cancrum oris primarily involve improving living conditions, nutrition, and oral hygiene practices in at-risk populations. Vaccination against certain types of bacteria may also be beneficial.

See Also

• Oral and maxillofacial surgery
• Oral hygiene
• Malnutrition