Cancrum Oris (Noma): The Role Of Nutrition In Management
Write short note on cancrum oris.
Answer. It is also called as NOMA or gangrenous stomatitis.
- It is a rapidly spreading gangrene of oral and facial tissues occurring in deliberated or nutritionally defiient person.
- The disease is caused by Borrelia vincentii and fusiformis bacteria.
“Noma and Malnutrition”
Cancrum Oris Predisposing Factors
- Low socioeconomic status: It occurs in people of low socio economic status or in poverty.
- Diseases: In debilitated diseases such as diphtheria,measles, pneumonia, scarlet fever, etc.
- Injury: In cases with mechanical injury.
- Immunodefiiency state: In AIDS
- Poor Oral hygiene: This leads to growth of bacteria causing increase chances of infection.
“Noma Nutrition Management”
Cancrum Oris Clinical Features
- It is seen chiefly in children mainly in malnourished children.
- The common sites are areas of stagnation around fied bridge or crown.
- The commencement of gangrene is denoted by blenching of skin.
- Small ulcers of gingival mucosa spread rapidly and involve surrounding tissue of jaws, lips and cheeks by gangrenous necrosis.
“Noma and Vitamin Supplementation”
- Odor is foul. Patient has high temperature during course of disease, suffrs secondary infection and may die from toxemia.
- Overlying skin is inflmed, edematous and fially necrotic which results in formation of line of demarcation between healthy and dead tissue.
- In advanced stage, there is blue black discoloration of skin.
- As gangrenous process advances, slough appears and soon separated, leaving perforating wound in involved area.
- The large masses maybe sloughed outleavingjaws exposed.
Cancrum Oris Treatment
- Systemic antibiotics should be given, i.e. high dose penicillin and metronidazole.
- Thorough nasogatric tube, high protein and vitamin rich diet should be given.
- Blood transfusion is given.
- Parenteral flid is given.
- Wound irrigationand liberal excision of dead tissue is done.
- Later on patient require flp to cover the defect.
“Noma Prevention Strategies”
Leave a Reply