Noma in an immunocompromised patient.

Area of Science:

• Oral Medicine
• Infectious Diseases
• Surgical Pathology

Background:

• Noma (cancrum oris) is a WHO-classified necrotizing ulcerative stomatitis affecting orofacial tissues.
• It predominantly impacts individuals with risk factors like severe malnutrition or compromised immune systems.

Observation:

• A case study of a 62-year-old immunocompromised patient presenting with noma.
• Symptoms included mandibular pain, tooth mobility, ulceration, bleeding, gingival discharge, and oral malodor.

Findings:

• Intravenous imipenem/cilastatin and vancomycin effectively controlled acute infection signs and symptoms.
• Surgical intervention for bone sequestration and maxillary sinus curettage was performed post-infection control.
• Post-operative treatment included 3 months of oral clindamycin.

Implications:

• This case underscores the importance of prompt antibiotic therapy and surgical management in noma treatment.
• Effective management can lead to successful outcomes even in immunocompromised patients.
• Highlights the role of specific antibiotics like imipenem/cilastatin, vancomycin, and clindamycin in noma treatment protocols.