Noma in an 18 months Toddler: A Rare Case Report with Review of Literature

J Maxillofac Oral Surg. 2024 Apr;23(2):320-327. doi: 10.1007/s12663-023-02046-8. Epub 2023 Nov 15.

Abstract

Introduction: Noma is a polymicrobial necrotizing infection of the mouth and face which destroys the soft and hard tissues of the oral and paraoral structures. Malnutrition, poverty, lack of basic hygiene, and chronic disease state etc., possess a risk of developing noma. Noma neonatorum is a progressive gangrenous disease affecting the premature infants.

Aim: We present a rare case of noma in an 18 months toddler with a chronic debilitating condition predisposing to the disease progression.

Results: The necrotizing infection of the face developed after six months of multiple episodes of chronic blood-tinged diarrhea. The facial defect was managed with release of fibrosis and reconstruction with a superiorly based nasolabial flap.

Discussion: Noma reflects extreme malnutrition and poverty with a vast range of etiopathological agents. This case emphasizes the need to understand the host risk factors and etiopathologic agent predisposing to this rare opportunistic and dormant but devastating disease, the morbidities associated with it and measures to prevent it.

Keywords: Cancrum oris; Gangrene; Noma; Noma neonatorum; Orofacial gangrene.