Noma (Cancrumoris) in the Western World

Noma (Cancrumoris) in the Western World
Malene Sine Rokkjaer* and Tejs Ehlers Klug

Abstract: 

Noma is a devastating orofacial gangrenous polymicrobial infection, which is predominantly seen in malnourished children in developing (especially sub-Saharan) countries. The pathogenesis is multifactorial and thought to result from a complex interaction between opportunistic, bacterial pathogens, poor oral hygiene, and malnutrition in patients debilitated by severe illness or immunosuppression. The disease is associated with high morbidity and mortality. Only few cases of noma have been described in the Western world and to our knowledge noma have not previously been reported in Scandinavia. We describe a 37-year-old Caucasian male admitted due to acute necrotizing stomatitis advancing to fulminant noma within few days. The case report illustrates that noma should be considered as a differential diagnosis in patients presenting with severe orofacial infections, even in the Western world.