CANCRUM ORIS UNMASKED :SYMPTOMS,RISK AND LIFE SAVING TREATMENT

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                                       CANCRUM ORIS(NOMA)

INTRODUCTION:

  • Cancrum oris is a Special type of gangrene
  • Extensive ulcerative disease of cheek mucosa occurring in malnourished children
  • Sign of gangrene :loss of pulsation, colour, temperature ,sensation, function
  • As disease progress, whole thickness of the cheek may be lost







PRECIPITATIG FACTORS:

  • Malnourishment
  • Major disease like diphtheria ,whooping cough, typhoid, measles, kala azar 
  • As a result of these factors opportunistic -borrelia vincentii and fusiform multiply and cause ulcer, erosion, fibrosis



CLINICAL FEATURE :

  • Lip-induration ,

edema -ischemia -necrotic -large area of lip ,cheek ja may be destroyed 

  • Painful condition
  • Patient ill ,anorexic
  • High temperature 






COMPLICATION:

  • Fibrosis causing restriction of the movement of jaw

septicemia, toxemia and death







TREATMENT :

  • Ryle tube feeding
  • Improve the nutrition
  • Appropriate antibiotics

Metronidazole 400 mg three times a day for 7-10days

Reconstructive surgery may be necessary later




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