MEDICO-DENTAL CASE RECORDS: SIXTH REPORT

A CLINICO-PATHOLOGICAL STUDY

¹ New York City

The incidence of noma in adults is not common, and this history narrates several interesting phases of the disease with regard to possible etiology, point of origin, course, treatment, and termination. The disease process originated from a small ulcer located on the buccal surface of the muco-periosteum adjacent to the right mandibular bicuspid, was complicated by Vincent's infection, spread rapidly through the tissues of the cheek, and resulted in widespread destruction of the face, which extended from the angle to a point approaching the symphysis of the mandible (involving the lower and upper lips almost to the median line, the ala of the nose), and superiorily to the infra-orbital structures and zygomatic process. In the terminal stages of the disease the patient became totally blind in the right eye, and showed severe signs of secondary anemia with marked cachexia. The primary fatal lesion was the extensive cancrum oris; the secondary or terminal lesion which caused death was edema of the glottis.