Noma Neonatorum From Multidrug-Resistant<i>Pseudomonas aeruginosa</i>: An Underestimated Threat?: Figure 1.

Raimondi, Francesco; Veropalumbo, Claudio; Coppola, Clara; Maddaluno, S.; Ferrara, Teresa; Cangiano, Giancarlo; Capasso, Letizia

doi:10.1093/jpids/piu072

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…Study findings indicate that children aged between 3 and 5 years had a higher prevalence of noma in comparison to those aged 2 years or less, a finding corroborated by other studies. [38][39][40][41] We hypothesise that this finding is likely due to the relationship between child feeding practices in Nigeria and malnutrition as a risk factor for noma. Our study did not identify an association between acute malnutrition and having noma.…”

Section: Discussionmentioning

confidence: 86%

The prevalence of noma in northwest Nigeria

Farley¹,

Oyemakinde

Schuurmans

et al. 2020

BMJ Glob Health

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BackgroundNoma, a rapidly progressing infection of the oral cavity, mainly affects children. The true burden is unknown. This study reports estimated noma prevalence in children in northwest Nigeria.MethodsOral screening was performed on all ≤15 year olds, with caretaker consent, in selected households during this cross-sectional survey. Noma stages were classified using WHO criteria and caretakers answered survey questions. The prevalence of noma was estimated stratified by age group (0–5 and 6–15 years). Factors associated with noma were estimated using logistic regression.ResultsA total of 177 clusters, 3499 households and 7122 children were included. In this sample, 4239 (59.8%) were 0–5 years and 3692 (52.1%) were female. Simple gingivitis was identified in 3.1% (n=181; 95% CI 2.6 to 3.8), acute necrotising gingivitis in 0.1% (n=10; CI 0.1 to 0.3) and oedema in 0.05% (n=3; CI 0.02 to 0.2). No cases of late-stage noma were detected. Multivariable analysis in the group aged 0–5 years showed having a well as the drinking water source (adjusted odds ratio (aOR) 2.1; CI 1.2 to 3.6) and being aged 3–5 years (aOR 3.9; CI 2.1 to 7.8) was associated with being a noma case. In 6–15 year olds, being male (aOR 1.5; CI 1.0 to 2.2) was associated with being a noma case and preparing pap once or more per week (aOR 0.4; CI 0.2 to 0.8) was associated with not having noma. We estimated that 129120 (CI 105294 to 1 52 947) individuals <15 years of age would have any stage of noma at the time of the survey within the two states. Most of these cases (93%; n=120 082) would be children with simple gingivitis.ConclusionsOur study identified a high prevalence of children at risk of developing advanced noma. This disease is important but neglected and therefore merits inclusion in the WHO neglected tropical diseases list.

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Section: Discussionmentioning

confidence: 86%

The prevalence of noma in northwest Nigeria

Farley¹,

Oyemakinde

Schuurmans

et al. 2020

BMJ Glob Health

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“…The strain showed resistance to penicillins, carbapenems, aminoglycosides, sulfamethoxazole-trimethoprim, and nitrofurantoin while being sensitive to colistin. A regimen of intravenous and topical colistin was followed for 3 weeks [3]. Nayak et all recently described a 25day-old Indian female infant that referred with facial tissue destruction and fever.…”

Section: Discussionmentioning

confidence: 99%

“…Especially it is observed during the first few weeks of neonatal life [1-2] and is mainly linked to Pseudomonas aeruginosa (P. aeruginosa), prematurity, and low birth weight. No established treatment in the few reported cases, and mortality is nearly inevitable [3]. In this report we have presented in a premature with noma neonatorum caused by Acinetobacter baumannii (A. baumannii).…”

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confidence: 93%

Noma Neonatorum Caused by Acinetobacter Sepsis in a Premature Baby

Yılmaz¹

2018

AJPN

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Noma neonatorum is characterized by a gangrenous phenomen affecting mucocutaneous junctions of mouth, nasal and anal area and occasionally, the eyelids and scrotum. Especially it is observed during the first few weeks of neonatal life [1-2] and is mainly linked to Pseudomonas aeruginosa (P. aeruginosa), prematurity, and low birth weight. No established treatment in the few reported cases, and mortality is nearly inevitable [3]. In this report we have presented in a premature with noma neonatorum caused by Acinetobacter baumannii (A. baumannii).

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“…Aetiology is usually polymicrobial by opportunistic organisms related to malnutrition and immune dysfunction. 14 Some writers have described Noma-like necro-ulcerative lesions involving the face for which, if diagnosed early, intensive therapy may limit progression and confer better prognosis. 15…”

Section: Introductionmentioning

confidence: 99%

Ecthyma gangrenosum on the face of a malnourished child with Pseudomonas sepsis: Simulating Cancrum oris

Sani

Waziri

et al. 2018

African Journal of Laboratory Medicine

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IntroductionEcthyma gangrenosum (EG) is a cutaneous lesion commonly caused by Pseudomonas aeruginosa that involves mainly the lower limbs and gluteal region, seen more in immunosuppressed patients with neutropenia. Cancrum oris (Noma) is a gangrenous necrosis of the face that begins as a gingival ulcer and progresses rapidly to destroy contiguous tissues in malnourished children.Case PresentationThis article reports a case of facial EG which was similar to Noma in a malnourished child: a 16-month old girl with fever, cough, weight loss, watery stool and swelling on right cheek. She was febrile, pale, wasted with bilateral pitting pedal oedema. She had a solitary circumscribed round necrotic lesion, with surrounding hyperaemia on the right malar area which extended to destroy the right ala nasi. No intra-oral rashes but she had left ear discharge. She received blood transfusion, antibiotics, antiseptic wound care and nutritional rehabilitation.Management and OutcomeSwabs of the lesion and ear discharge both revealed Gram-negative bacilli and culture yielded P. aeruginosa. Retroviral, Mantoux and Gene Xpert tests were negative. She had moderate anaemia, normal white blood cell count, and neutropaenia. Parenteral ceftriazone was changed to ciprofloxacin based on sensitivity results and lack of clinical response. The wound healed with residual scarring and partial destruction of right ala nasi.DiscussionAlthough this patient had facial necrosis to suggest Noma, she did not have initial oral involvement, and clinical features such as Pseudomonas sepsis and neutropaenia suggested EG. Facial necrosis in malnourished children may be due to EG.

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Noma Neonatorum From Multidrug-ResistantPseudomonas aeruginosa: An Underestimated Threat?: Figure 1.

Cited by 6 publications

References 11 publications

The prevalence of noma in northwest Nigeria

The prevalence of noma in northwest Nigeria

Noma Neonatorum Caused by Acinetobacter Sepsis in a Premature Baby

Ecthyma gangrenosum on the face of a malnourished child with Pseudomonas sepsis: Simulating Cancrum oris

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