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Noma Masquerading as Squamous Cell Carcinoma - A Case Report in an AIDS Patient
R Mahesh Kumar1, T R Marimallappa1, M S Sreelakshmi1
1Department of Oral and Maxillofacial Surgery, Sri Siddhartha Dental College and Hospital, Sri Siddhartha Academy of Higher Education, Tumakuru, Karnataka, India.
Rationale:
Cancrum oris, also known as noma, is a rare and rapidly progressing gangrenous infection affecting the oral cavity, commonly seen in malnourished children. We discuss the clinical presentation, diagnostic dilemma and management in a 54-year-old male human immunodeficiency virus-positive patient with oral ulceration clinically resembling squamous cell carcinoma (SCC).
Patient Concerns:
The patient had severe oral ulceration with pain and difficulty eating food.
Diagnosis:
Histopathological examination was misleading as it revealed features akin to early invasion of SCC. Immunohistochemistry findings were not in favour of SCC.
Treatment:
Antiretroviral therapy was started owing to the decreased CD4 cell count.
Outcomes:
Lesions began to show signs of healing on follow-up.
Take-Away Lessons:
This case aims to highlight the unique challenges of diagnosing and emphasises the importance of considering opportunistic infections in immunocompromised patients presenting with oral ulcerations to prevent misdiagnosis and maltreatment.
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