Noma (cancrum oris) in the South African context.

Noma (cancrum oris) is a destructive necrotising disease affecting orofacial tissues predominantly of malnourished young children. It is characterised by a rapid acute onset which usually starts in the mouth, spreads intra-orally destroying soft tissue and bone and progresses to perforate the facial skin, causing disfigurement. Polybacterial anaerobic infection is critical too, but is not alone sufficient for the initiation of noma. Cofactors, first and foremost malnutrition, but also systemic viral and bacterial infections are crucial to the development of noma. A patient with necrotising stomatitis or noma must be admitted to hospital for antibiotic treatment, fluid and electrolytes as well as nutritional supplementation and general supportive treatment. The epidemiology of noma in the South African population is unknown, and the clinicopathological features are poorly characterised. Although worldwide there is no evidence that HIV infection is a strong risk factor for noma, HIV infection may play a substantial role in the pathogenesis of noma in South Africa.

Noma (cancrum oris): a report of a case in a young AIDS patient with a review of the pathogenesis.

Noma (cancrum oris) is a mutilating necrotising disease of the orofacial tissues. It affects predominantly debilitated malnourished children, in whom the necrotic process may cause severe damage to mid-facial structures. Its aetiopathogenesis is uncertain, but its course is fulminating, and without timely intervention the disease may be fatal. Antibiotic treatment during any stage of necrotising stomatitis and of its sequel noma can stop progression of the disease; therefore detection and treatment of early intraoral necrotising lesions whether necrotising gingivitis, necrotising periodontitis or necrotising stomatitis are critical in preventing noma. We present an extreme case of noma in a malnourished HIV-seropositive child. There was an acute necrotic process affecting both the maxilla and the mandible with denudation of bone, spontaneous exfoliation of teeth, necrotising fasciitis and myonecrosis which destroyed the lips and cheeks and extended to the infra-orbital margins. There was severe disfigurement and severe impairment of function. Noma is primarily an anaerobic bacterial infection with secondary ischaemia leading to osteonecrosis and mid-facial destruction.

Primary oral melanoma associated with HIV infection.

POM, when it occurs, is most common in the palate and the maxillary gingiva. It has a poor prognosis. Surgical excision is the treatment of choice while radiotherapy and chemotherapy are adjunctive. This report documents an unusual case of POM and reviews field cancerization in POM.

Orbital abscess as a complication of odontogenic infection. A case report and review of the literature.

Orbital abscess is a rare complication of odontogenic infection. This report describes a case of an orbital abscess in a 42-year-old HIV-seropositive woman who developed this condition as a complication by direct spread via the maxillary sinus of a dento-alveolar abscess of the maxillary first premolar, resulting in the loss of her eye.

Oral carriage of Candida species in patients visiting the Medunsa Dental Clinic.

148 Healthy adults visiting the Medunsa Dental Clinic were screened for the presence of oral candida species. Fifty-three per cent of these subjects harboured candida with a higher prevalence in females (61 per cent) than in males (44 per cent). Candida carriage was not significantly influenced by plaque or gingival indices. There was no significant difference in prevalence between smokers and non-smokers in the group as a whole, but smoking males showed a significantly higher prevalence than non-smoking males (p < 0.05).