Noma is a relatively unknown but devastating opportunistic infection of the face that occurs in the setting of extreme poverty. Noma cases are concentrated within the “noma belt,” a region that extends from Senegal to Ethiopia where malnutrition is endemic.1 Acute noma begins in the gingiva as a necrotizing lesion, progressing rapidly through the hard and soft tissues of the face (Figure 1).2 Untreated noma carries a 90% mortality rate.3,4 Survivors are left with complex facial deformities in a low-resource setting (Figure 2).5
Shaye DA, Rabbels J, Adetunji AS, Magee A, Vo D, Winters R. Evaluation of the Noma Disease Burden Within the Noma Belt. JAMA Facial Plast Surg. Published online April 12, 2018. doi:10.1001/jamafacial.2018.0133
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