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Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection.
C O Enwonwu
C O Enwonwu
Department of Oral and Craniofacial Biological Sciences, School of Dentistry, University of Maryland, Baltimore 21201, USA.
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W A Falkler Jr
W A Falkler Jr
Department of Oral and Craniofacial Biological Sciences, School of Dentistry, University of Maryland, Baltimore 21201, USA.
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E O Idigbe
E O Idigbe
Department of Oral and Craniofacial Biological Sciences, School of Dentistry, University of Maryland, Baltimore 21201, USA.
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B M Afolabi
B M Afolabi
Department of Oral and Craniofacial Biological Sciences, School of Dentistry, University of Maryland, Baltimore 21201, USA.
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M Ibrahim
M Ibrahim
Department of Oral and Craniofacial Biological Sciences, School of Dentistry, University of Maryland, Baltimore 21201, USA.
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D Onwujekwe
D Onwujekwe
Department of Oral and Craniofacial Biological Sciences, School of Dentistry, University of Maryland, Baltimore 21201, USA.
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O Savage
O Savage
Department of Oral and Craniofacial Biological Sciences, School of Dentistry, University of Maryland, Baltimore 21201, USA.
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V I Meeks
V I Meeks
Department of Oral and Craniofacial Biological Sciences, School of Dentistry, University of Maryland, Baltimore 21201, USA.
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This study showed that impoverished Nigerian children at risk for cancrum oris (noma) had significantly reduced plasma concentrations of zinc (< 10.8 micromol/L), retinol (< 1.05 micromol/L), ascorbate (< 11 micromol/L), and the essential amino acids, with prominently increased plasma and saliva levels of free cortisol, compared with their healthy counterparts. The nutrient deficiencies, in concert with previously reported widespread viral infections (measles, herpesviruses) in the children, would impair oral mucosal immunity. We postulate, subject to additional studies, that evolution of the oral mucosal ulcers including acute necrotizing gingivitis to noma is triggered by a consortium of microorganisms of which Fusobacterium necrophorum is a key component. Fusobacterium necrophorum elaborates several dermonecrotic toxic metabolites and is acquired by the impoverished children via fecal contamination resulting from shared residential facilities with animals and very poor environmental sanitation.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 324 | 236 | 14 |
| Full Text Views | 467 | 10 | 0 |
| PDF Downloads | 331 | 13 | 0 |