A severely malnourished child developed fever, leucocytosis, mal-odorous breath and necrotic ulceration of cheek around 2 weeks after a episode of severe diarhhoea. In consideration of severely malnourished status of this child the lesion demonstrated in the adjoining photograph is diagnostic of ?

  1. a) Flaky paint dermatosis
  2. b) Icthyosis gangrenosum
  3. c) Noma lesion
  4. d) Aphthous ulcer

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One thought on “A severely malnourished child developed fever, leucocytosis, mal-odorous breath and necrotic ulceration of cheek around 2 weeks after a episode of severe diarhhoea. In consideration of severely malnourished status of this child the lesion demonstrated in the adjoining photograph is diagnostic of ?

  1. Correct answer is (C). Noma lesion
    Exp.
    REF : Nelson 18th Ed. Chapter. 43.
    Noma is a chronic necrotizing ulceration of the gingiva and the cheek. It is associated with malnutrition and is often preceded by a debilitating illness (measles, malaria, tuberculosis, diarrhea, ulcerative gingivitis) in a nutritionally compromised host. Noma presents with fever, malodorous breath, anemia, leukocytosis, and signs of malnutrition. If untreated, it produces sever disfiguration. Polymicrobial infection with Fusobacterium necrophorum and Prevotella intermedia may be inciting agents. Treatment includes local wound care, penicillin, and metronidazole as well as therapy for the underlying predisposing condition.

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