Noma (cancrum oris): An unresolved global challenge.

Area of Science:

• Oral and Maxillofacial Surgery
• Infectious Diseases
• Pediatrics

Background:

• Noma (cancrum oris) is a severe necrotizing disease of uncertain cause.
• It involves polybacterial infection and secondary ischemia, leading to facial structure destruction.
• Noma primarily affects malnourished or debilitated children in sub-Saharan Africa, often linked to systemic illnesses.

Purpose of the Study:

• To summarize the etiology, clinical presentation, and epidemiology of noma.
• To highlight the severe functional impairment and disfigurement associated with the disease.
• To discuss the role of pre-existing conditions and oral lesions in noma development.

Main Methods:

• Literature review of noma etiology and clinical characteristics.
• Analysis of epidemiological data concerning noma prevalence.
• Synthesis of information on associated risk factors and preceding conditions.

Main Results:

• Noma is characterized by necrotizing fasciitis, myonecrosis, and osteonecrosis.
• Malnutrition, malaria, measles, tuberculosis, and HIV debilitation are significant risk factors.
• While often preceded by necrotizing stomatitis, noma can rarely occur without prior oral lesions.

Conclusions:

• Noma is a devastating disease requiring prompt recognition and management.
• Understanding its multifactorial etiology is crucial for prevention and treatment strategies.
• Noma is neither recurrent nor transmissible, but its impact on affected individuals is profound.