01849nas a2200325   4500000000100000008004100001653001700042653001700059653000900076653000900085653001100094653003900105653001100144653002400155653003000179653002600209653001000235100001300245700001300258700001500271700002000286700001500306700001400321700001300335245005400348300000800402490000700410520109200417022001401509       2014                            d10aSouth Africa10aRisk Factors10aNoma10aMale10aHumans10aGingivitis, Necrotizing Ulcerative10aFemale10aDisease Progression10aCombined Modality Therapy10aAnti-Bacterial Agents10aAdult1 aFeller L1 aAltini M1 aChandran R1 aKhammissa R A G1 aMasipa J N1 aMohamed A1 aLemmer J00aNoma (cancrum oris) in the South African context.  a1-60 v433 a<p>Noma (cancrum oris) is a destructive necrotising disease affecting orofacial tissues predominantly of malnourished young children. It is characterised by a rapid acute onset which usually starts in the mouth, spreads intra-orally destroying soft tissue and bone and progresses to perforate the facial skin, causing disfigurement. Polybacterial anaerobic infection is critical too, but is not alone sufficient for the initiation of noma. Cofactors, first and foremost malnutrition, but also systemic viral and bacterial infections are crucial to the development of noma. A patient with necrotising stomatitis or noma must be admitted to hospital for antibiotic treatment, fluid and electrolytes as well as nutritional supplementation and general supportive treatment. The epidemiology of noma in the South African population is unknown, and the clinicopathological features are poorly characterised. Although worldwide there is no evidence that HIV infection is a strong risk factor for noma, HIV infection may play a substantial role in the pathogenesis of noma in South Africa.</p>
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