Cancrum Oris (Noma): The Role of Nutrition in Management

Cancrum oris (noma) is caused by the spirochete Borrelia vincenti in association with anaerobic bacteria, commonly a member of the fusobacteria. The disease occurs in deprived and undernourished individuals with poor hygiene. We present a case of clinically diagnosed cancrum oris in a 2-year old child in sub-saharan Africa that was conservatively managed by wound care and hyperalimentation. As the underlying factor and cause of mortality from noma is the immune depression of malnutrition, the role of active nutrition or hyperalimentation in the management of noma is extremely important.