noma Nome (Gangrenous disease, cancer of Water) - a serious disease characterized by gangrenous lesion tissues of the face and mouth.Noma is expressed in the development of putrid necrotic process, which begins with the mucosa and tends to further a very rapid spread and destroy tissue.Gangrenous lesion of this nature is sometimes observed in girls on the external genitals, after undergoing measles and other infectious diseases.According to statistics from the World Health Organization, from the disease affect approximately 500,000 people (especially in Africa), and each year, about 100,000 more new cases


Today etiology of noma is not fully understood.It is believed that the agent is in symbiosis with the spirochete B. Fusiformis.There is also reason to believe that the agent can be aerobic infection.In most cases the genome affects young children, frail and emaciated previous infectious disease (often dysentery, typhoid and measles).Depending on the degree of weakening of th

e immune defense, the defeat of the oral mucosa and tissues of the face may be different - from catarrhal to necrotizing stomatitis.After the appearance of necrosis, there is a connection of other bacteria (anaerobic and so forth.), So the infection of nome always is mixed.Contributing factors of this disease are: substandard hygiene and oral injuries and facial injuries


The clinical picture is characterized by the rapid current.On the skin of the face or the oral mucosa occurs inflammatory center, which is a vial filled with muddy contents, turning fast enough in the ulcer.The surrounding skin become waxy pearl tinge, nearby tissues swell and become dense to the touch.The process begins to spread very quickly deep into the soft tissue (about three days), passing on the cheek and the corner of his mouth.The skin in the affected areas turn blue and then quickly turn black.Necrotic tissue and begin to fall off partially, thereby forming a hole leading into the oral cavity, which can be seen through the naked edge of the jaw and teeth;there is a sharp putrid odor.Total body temperature rises to 40 *, there are symptoms of severe intoxication.As a result of acceding alveolar necrosis, and start to become loose teeth fall out.On the upper jaw necrosis sometimes goes to heaven.

In severe cases, necrotizing process inexorably progresses and people die from sepsis within a few days (mortality in nome about 70%).In other cases, around the affected area formed granulation oval, necrotic tissue are separated and wound scarring.The healing process after gradually cleanse the wound is very slow, and the place of dead tissue forms ugly severe scarring


treatment of noma necessarily performed in a hospital and is to appoint a broad-spectrum antibiotics, sulfonamides andconduct detoxification therapy.In parallel, restorative treatment, which includes good nutrition and vitamin therapy.The patient is assigned to wash the mouth with warm p - rum potassium permanganate or furatsilina.In the affected areas of bandage with antibiotic penicillin administered intramuscularly.Cosmetic defects on the cheek and the corner of his mouth are corrected with the help of plastic surgery.

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