A 40-Year-Old Man With a Perforated Cheek

Silva, Kathryn N.; Twaddell, William S.; Powers, David B.; Mackowiak, Philip A.; Frayha, Neda; Silhan, Leann

doi:10.1097/maj.0b013e3181e2ed3e

Cited by 6 publications

(6 citation statements)

References 18 publications

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“…Stage 4: scarring and Stage 5: sequelae [ 1 ]. Deaths in noma patients are primarily reported to be due to starvation, aspiration pneumonia, respiratory insufficiency or sepsis [ 13 , 128 ]. Even though noma primarily affects young children [ 2 ], noma cases in adults, mostly in conjunction with other severe infections (like HIV, cancer or oral myiasis) have been reported [ 76 , 82 , 95 , 150 ].…”

Section: Resultsmentioning

confidence: 99%

Noma (cancrum oris): A scoping literature review of a neglected disease (1843 to 2021)

Farley

Mehta

Srour³

et al. 2021

PLoS Negl Trop Dis

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Background Noma (cancrum oris) is an ancient but neglected and poorly understood preventable disease, afflicting the most disenfranchised populations in the world. It is a devastating and often fatal condition that requires urgent and intensive clinical and surgical care, often difficult to access as most cases of noma occur in resource-limited settings. We conducted a scoping review of the literature published on noma to understand the size and scope of available research on the disease and identify research gaps that need to be addressed to evolve our understanding of how to address this disease. Methods We searched 11 databases and collected primary peer reviewed articles on noma in all languages, the final search was conducted on 24th August 2021. The oldest manuscript identified was from 28th March 1843 and the most recently published manuscript was from 3rd June 2021. Search terms included cancrum oris and noma. Data was extracted using a standardised data extraction tool and key areas of interest were identified. The Preferred Reporting Items for Systemic review and Meta-Analyses requirements were followed. Results The review included 147 articles, the majority of the studies (n = 94, 64%) were case reports. Most manuscripts (n = 81, 55%) were published in the 2000s, 49 (33%) were from the 1900s and 17 (12%) from the 1800s. The main areas of interest identified were the history and epidemiology of the disease, noma’s clinical progression and aetiology, treatment regimens, mortality rates and the risk factors for the development of noma. Conclusions Noma has been reported in the literature for hundreds of years; however important gaps in our understanding of the disease remain. Future research should focus on determining the burden and distribution of disease; the true mortality rate, pathogenic cause(s) and the factors that influence prognosis and outcomes after treatment.

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Section: Resultsmentioning

confidence: 99%

Noma (cancrum oris): A scoping literature review of a neglected disease (1843 to 2021)

Farley

Mehta

Srour³

et al. 2021

PLoS Negl Trop Dis

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“…Three articles were not included because the full text data is not available [19,20,21], and eight articles were excluded because patients have the diagnosis of necrotizing ulcerative gingivitis and not noma. Finally, 24 publications that reported 133 cases of noma or noma-like disease in HIV/AIDS patients in the last 22 years, from 1994 to 2016, were selected and included for this review [10][11][12][13][15][16][17][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Most of the HIV/AIDS patients of this review who develop noma-like disease have never been in antiretroviral therapy and some have stopped their treatment; in fact, in many cases, their HIV infection was discovered because of noma, and noma-like disease was the first manifestation of AIDS [3]. This highlights the importance of stablishing the HIV state of noma-like disease patients, especially in adults but also in children, for initiating appropriate antiretroviral therapy; other reports have also addressed the risk of stopping HIV treatment, progression of the disease and development of noma-like disease [3,16,25,27,28,33,34].…”

Section: Discussionmentioning

confidence: 99%

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Noma and Noma-like disease in HIV/AIDS patients, a comorbid interaction: A systematic review

Calleros

Castillo-Ventura

Jiménez-Escobar

et al. 2018

J Infect Dev Ctries

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Introduction: Noma is an opportunistic polymicrobial infection that cause necrosis of the mouth and face, with high morbidity and mortality, predominantly affecting malnourished children and persons with debilitating diseases. Cases of noma-like disease in adults, although rare, have been increasingly reported in HIV/AIDS patients particularly in developing countries but also in more developed countries. Methodology: A systematic review of the literature to assess the occurrence and clinical impact of noma and noma-like disease in HIV/AIDS patients was performed on PubMed, Virtual Health Library, Cochrane Library and Google Scholar using the keywords "HIV"[ All Fields] AND "Noma"[All Fields] in December 2016 (years includead for the search: 1985 to 2016). Results: Twenty-four published studies were identified that document the occurrence of noma or noma-like disease in a total of 133 HIV/AIDS children and adult patients in the last 22 years. Although HIV infection is not the principal risk factor for noma, in some regions may play a substantial role in its pathogenesis. The mortality rate for noma-like disease in HIV/AIDS patients was 54.3%, compared to the 15% mortality rate of treated noma patients without HIV/AIDS. Most of the cases have never been on antiretroviral therapy, and their HIV infection was discovered because of the noma-like disease. Conclusions: The syndemic interaction between HIV/AIDS and noma-like disease adversely impacts the severity of the disease and the mortality rate. Noma-like disease, although not yet considered a specific or frequent disease associated with HIV infection, should be considered as an opportunistic infection for AIDS.

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“… 3 Cases in adults and citizens of high income countries are exceedingly rare and have been limited to those with immunodysfunction. 4 , 5 , 6 We report a case of noma in an immunocompetent man who presented to an urban hospital in the United States.…”

Section: Introductionmentioning

confidence: 98%