       Document 0400
 DOCN  M9650400
 TI    [Noma or cancrum oris: etiopathogenic and nosologic aspects]
 DT    9605
 AU    Costini B; Larroque G; Duboscq JC; Montandon D; Service de Chirurgie
       Maxillo-faciale et Plastique de la Face,; Centre Hospitalier
       Universitaire Nord, Marseille, France.
 SO    Med Trop (Mars). 1995;55(3):263-73. Unique Identifier : AIDSLINE
       MED/96141177
 AB    Noma is a gangrenous disease that usually begins in the mouth and is
       characterized by rapid necrotizing destruction of soft tissue and
       underlying bone. The disease, which is associated with a strong putrid
       odor suggestive of mixed bacterial infection, develops only in
       predisposed persons, especially children whose natural defenses have
       been weakened by poor socio-economic living conditions. However a few
       atypical cases have recently been reported in adults in whom the main
       risk factor seemed to be immunodepression. The increasing number of wars
       in the Third World and the AIDS epidemic raise the likelihood that the
       number of cases of this disease will rise sharply particularly since the
       incidence has been grossly underestimated for many years. It now seems
       clear that a combination of local and systemic risk factors are
       implicated in the etiopathogenesis of noma with the common denominator
       being a weakened immune system. This would account for the fulminating
       course of the infectious process due to one or more opportunistic
       microbial or cytopathogenic agents or even to a still undetermined
       immunopathologic reaction that lead to massive tissue destruction. Poor
       understanding of the etiopathogenesis of noma is a major factor
       perpetuating the nosologic problems posed by this disease. Some authors
       add to the confusion by including a range of gangrenous diseases under
       the heading of noma. It is important that the term noma be applied only
       to necrotizing processes that begin in the mouth and present the
       characteristic features and course.
 DE    Adult  Child  Child Nutrition Disorders/COMPLICATIONS  English Abstract
       Human  Immunocompromised Host  Incidence  Infant, Newborn
       Noma/CLASSIFICATION/EPIDEMIOLOGY/*ETIOLOGY  Nomenclature  Oral Hygiene
       Risk Factors  Socioeconomic Factors  World Health  JOURNAL ARTICLE
       REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

