Pustaka Ilmiah Universitas Padjadjaran

Abstrak

NOMA MANAGEMENT IN A CHILD WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Introduction: Noma, also known as cancrum oris, is an orofacial gangrene, which during its fulminating course causes progressive and mutilating destruction of the infected tissues. The disease occurs mainly in children with malnutrition, poor oral hygiene and debilitating concurrent illness.
Objectives: The aim of this paper is to report a case of noma associated with SLE in a 8-year-old Children, identification of risk factors and it’s management.

Case Report:A 8-year-old boy referred to Oral Medicine Department complained an ulcer at the left corner of his mouth for 1 months, painful and difficulty in opening the mouth. The patient was diagnosed systemic lupus erythematosus since 14 months ago and has been given immunosuppressive therapy. The patient was malnourished and weighed only 14 kg. Panoramic radiography was performed to check for dental or periodontal foci of infection, but no abnormalities were evident. Hematologic investigations revealed anemia. The patient has been treated oral irrigation with hydrogen peroxide, saline and 0.2% chlorhexidine, thus helps to slough the necrotic tissue. Oral antibiotics and analgesics were prescribed. The patient was admitted to hospital under the care of a pediatrician for evaluation of SLE and by a nutritionist for malnutrition. Its physical effects are permanent and may require reconstructive surgery to repair by oral surgeon.

Conclusions: Noma is not a primary disease, there are various predisposing factors usually precede its occurrence. The management of noma requires a multidisciplinary team approach.