I was going through my rare and tropical diseases book from the 1980s. I was trying to find something I’ve never ever heard of before and read about it. 
This is Noma. It can be cause by a plethora of bacteria. And is considered a disease of extreme poverty. It was described by Hippocrates and found in German and Japanese concentration camps during World War II. It seems to be multifactorial, malnutrition plus poor oral hygiene plus the right bacteria = total facial destruction and high mortality. 
A good case and review article published on Noma: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3006140/
From the Journal of Neglected Tropical Diseases. Appropriate journal. 


Noma, or cancrum oris, is a rapidly progressive bacterial disease that results in painless gangrenous necrosis of the mouth.


Noma is a disease of multifactorial etiology that presupposes a state of malnutrition; historically, it has been found worldwide during times of poverty, starvation, and war, including within the concentration camps of WWII.


Estimated incidence of noma is 100,000 to 140,000 per year with a worldwide prevalence documented at over 700,000 cases. This may severely underestimate the actual figures, though, as it is believed that fewer than 15% of acute cases present for care.


Untreated, acute noma in children is 80%–90% lethal. Antibiotic treatment and nutritional support decreases mortality to less than 10%. Nevertheless, plastic orofacial reconstruction is often necessary for both functionality and cosmesis.

I was going through my rare and tropical diseases book from the 1980s. I was trying to find something I’ve never ever heard of before and read about it. 

This is Noma. It can be cause by a plethora of bacteria. And is considered a disease of extreme poverty. It was described by Hippocrates and found in German and Japanese concentration camps during World War II. It seems to be multifactorial, malnutrition plus poor oral hygiene plus the right bacteria = total facial destruction and high mortality. 

A good case and review article published on Noma: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3006140/

From the Journal of Neglected Tropical Diseases. Appropriate journal. 

  • Noma, or cancrum oris, is a rapidly progressive bacterial disease that results in painless gangrenous necrosis of the mouth.
  • Noma is a disease of multifactorial etiology that presupposes a state of malnutrition; historically, it has been found worldwide during times of poverty, starvation, and war, including within the concentration camps of WWII.
  • Estimated incidence of noma is 100,000 to 140,000 per year with a worldwide prevalence documented at over 700,000 cases. This may severely underestimate the actual figures, though, as it is believed that fewer than 15% of acute cases present for care.
  • Untreated, acute noma in children is 80%–90% lethal. Antibiotic treatment and nutritional support decreases mortality to less than 10%. Nevertheless, plastic orofacial reconstruction is often necessary for both functionality and cosmesis.

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