Noma in a Pacient whitout Sistemic Involvement
DOI:
https://doi.org/10.33448/rsd-v14i1.48022Keywords:
Noma, Gingival necroses, Periodontitis.Abstract
Noma, also known as Cancrum oris or gangrenous stomatitis, is an infectious disease of bacterial origin, often in association with other microorganisms, affecting orofacial tissues and manifesting through a sequence of precursors. It begins as necrotizing gingivitis and progresses to necrotizing periodontitis and necrotizing stomatitis. In advanced stages, it can lead to facial mutilations, difficulty in eating, and psychological distress due to social stigma. Untreated, it can result in a mortality rate of up to 90%, mainly due to septicemia, dehydration, and malnutrition. When addressed early, the prognosis is favorable, and by treating its precursors, it is challenging to reach severe stages. The disease is often associated with children in impoverished social conditions, weakened immune systems, and malnutrition, especially in regions with low human development indices, such as sub-Saharan Africa, although some cases have been reported elsewhere. Treatment involves several phases, including debridement of necrotic areas, antibiotics, antimicrobial mouth rinses, and supportive periodontal therapy. Despite its rarity, infection can also occur in developed countries and affect adult patients, sometimes without underlying health conditions. The aim of this article is to report a clinical case of noma in a 31-year-old man, without systemic involvement, who sought treatment at the Maria Aparecida Pedrossian University Hospital in Campo Grande, Mato Grosso do Sul, Brazil, due to swelling in the submental region. After hospitalization, biofilm control and postoperative care, there was a satisfactory improvement in the clinical condition.
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Ahern, D. C., Schweitzer, C. M., Castro, A. L. de, Coclete, G. A., Okamoto, A. C., & Gaetti-Jardim Jr, E. (2014). Susceptibilidade antimicrobiana ao metronidazol de microrganismos isolados de periodontite crônica e agressiva. Archives of Health Investigation, 3(1), 8-14.
Baratti-Mayer, D., Gayet-Ageron, A., Hugonnet, S., Françoism P., Pittet-Cuenod, B., Huyghe, A., et al. (2013). Risk factors for noma disease: a 6-year, prospective, matched case-control study in Niger. The Lancet Global Health, 1(2), e87-e96.
Brandão, J. F., Garcia, S. G. M., Zago, P. M. W., & Tognetti, V. M. (2022). O uso de antibióticos como adjuvante no tratamento da periodontite. Revista Ensaios Pioneiros, 6(2), 33-45.
Dholam, K. P., Parkar, S. P., Dugad, J. A., Kharade, P. P., Shinde, A. A., & Gurav, S. V. (2022). Development of a psychosocial perception scale and comparison of psychosocial perception of patients with extra oral defects before and after facial prosthesis. Journal of Prosthetic Dentistry, 128(6), 1398–1404.
Engels, D., & Zhou, X. N. (2020). Neglected tropical diseases: an effective global response to local poverty-related disease priorities. Infectious Diseases of Poverty, 9(1), 10.
Feller, L., Khammissa, R. A. G., Altini, M., & Lemmer, J. (2019). Noma (cancrum oris): An unresolved global challenge. Periodontology 2000, 80(1), 189-199.
Feller, L., Lemmer, J., & Khammissa, R. A. G. (2022). Is noma a neglected/overlooked tropical disease? Transactions of The Royal Society of Tropi-cal Medicine and Hygiene, 116(10), 884–888.
Gasner, N. S., & Schure, R. S. (2024). Necrotizing Periodontal Diseases. StatPearls. StatPearls Publishing.
Khammissa, R. A. G., Lemmer, J., & Feller, L. (2022). Noma staging: a review. Tropical Medicine and Health, 50(1), 40.
Luchian, I., Goriuc, A., Martu, M. A., & Covasa, M. (2021). Clindamycin as an Alternative Option in Optimizing Periodontal Therapy. Antibiotics, 10(7), 814.
Maley, A., Desai, M., & Parker, S. (2014). Noma: A disease of poverty presenting at an urban hospital in the United States. Journal of the American Academy of Dermatology Case Reports, 1(1), 18-20.
Masipa, J. N., Baloyi, A. M., Khammissa, R. A., Altini, M., Lemmer, J., & Feller, L. (2013). Noma (cancrum oris): a report of a case in a young AIDS patient with a review of the pathogenesis. Head and Neck Pathology, 7(2), 188–192.
Nolte, S. H. (2021). From trench mouth to noma: Experiences from Nazi extermination camps. Clinical of Dermatology, 39(6), 990-995.
Ogunleye, R., Ukoha, O., Nasterska, W., McColl, E., Dantata, F., & Adetula, I. (2022). Necrotising periodontal diseases: an update on classification and management. British Dental Journal, 233(10), 855-858.
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.
Schneidereit, N. G., Silva, K. M. R., Barra, R. H. D., Okamoto, A. C., Jardim, E. C. G., Schweitzer, C. M., & Jardim Júnior, E. G. (2023). Resistência ao metronidazol entre anaeróbios obtidos de amostras de água 'in natura' e de espécimes clínicos bucais. Ciência Brasileira: Múltiplos olhares - Nutrição, Biologia, Biomedicina e Meio Ambiente.
Silva, D. F, Silva, H. M. C, Silva, L. D. S. S, Ferreira, A. B. S, Silva, C, K, M, Biagiote, J. A. C. D. S & Cota, A. L. S (2020). Aspectos relevantes sobre a doença noma e a importância do conhecimento pelos cirurgiões-dentistas: revisão integrativa. Research, Society and Development, 9(7): 1-18, e745975393.
Singh, M., Samal, D., & Kar, I. B. (2024). Noma in an 18 months Toddler: A Rare Case Report with Review of Literature. Journal of maxillofacial and oral surgery, 23(2), 320–327. https://doi.org/10.1007/s12663-023-02046-8.
Tkacz, K., Gill, J., & McLernon, M. (2021). Necrotising periodontal diseases and alcohol misuse - a cause of osteonecrosis? British Dental Journal, 231(4), 225–231.
Whiteson, K. L., Lazarevic, V., Tangomo-Bento, M., Girard, M., Maughan, H., Pittet, D., et al. (2014). Noma affected children from Niger have distinct oral microbial communities based on high-throughput sequencing of 16S rRNA gene fragments. PLoS neglected tropical diseases, 8(12), e3240.
WHO. (2017). Brochura informativa para a detecção e tratamento precoces do NOMA: O noma é uma doença grave. É curável se for detectada a tempo! Escritório Regional da OMS.
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Copyright (c) 2025 Vinícius Cezak Santos; Rafael Ferreira; Gleyson Kleber do Amaral Silva; Gustavo Silva Pelissaro; Elerson Gaetti-Jardim Júnior; Ellen Cristina Gaetti-Jardim
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