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Pathophysiology Rua Essay

1214 words - 5 pages

Pathophysiology Processes & Consequences of Noma
Chamberlain College of Nursing
NR283: Pathophysiology
May 2016, Professor (Name Here)

Pathophysiology Processes & Consequences of Noma
Noma disease, commonly referred to as cancrum oris, fusospirochetal gangrene, necrotizing ulcerative stomatitis, and stomatitis gangrenosa is a devastating disease that is famously quoted as “the face of poverty”. This rare disease with high prevalence in Sub-Saharan countries is lethal and has been linked to acute and rapid disease progression in persons that are immunocompromised. Evidence based research suggests a high prevalence of the disease is observed in populations experiencing ...view middle of the document...

, 2014). Noma was first discovered in concentration camps during World War II, and is most commonly found in children. Noma, for most people is a disease of shame; the prevalence and processes from derivations are completely unknown due to only 15% of acute cases seeking medical care while others go into isolation.
Pathophysiological Process
The rapid destruction and deterioration of the hard and soft tissues that display physiologic characteristics in response to the pathological processes of Noma, can be attributed to an immuno-pathological response to microbial factors rather than the microbiological factors alone (Ashok, Tarakji, Darwish, Rodrigues , & Altamimi, 2016). Noma’s multifactorial nature and origin is considered infectious and mostly recognized as opportunistic rather than communicable. The onset of Noma with mucosal ulcerations may show limited activity for an extended period of time prior to progressing to associated tender stomatitis and edema. A painless necrotic center develops, with an outward expansion following a sharp perimeter; the infection will rapidly spread across local tissue types and planes, affecting skin turgor dramatically. The sloughing of tissue on the face exposes mandibular and maxillary bone leading to facial deformities, oral incontinence, and severe pain. This consumptive gangrene progression for survivors require surgical reconstruction to achieve and regain functionality (Tonna, Lewin, & Mensh, 2010).
Clinical Manifestations & Complications
Noma’s early and progressed clinical manifestations include signs of edema in the cheek, malodorous breath, excessive salivation, anemia, severe dehydration, and symptoms of both acute and chronic kwashiorkor (Tonna, Lewin, & Mensh, 2010). A greyish-black area appears on the outside of the opposite cheek within a couple days, which then becomes a black necrotic spot. Physiologic manifestations include fever, tachycardia, increased respiratory rate, general edema, leukocytosis and lymphadenopathy, indicating acute infection. High, rapid mortality rates used to be a common result of Noma, however with recent use of antibiotics and better nutrition, the mortality rate has reduced from 90% to 8 -10% (Ashok, Tarakji, Darwish, Rodrigues , & Altamimi, 2016). Other complications presented by Noma include trismus, alveolar bone destruction, and sepsis. Many survivors of Noma experience trouble chewing due to the loss of tissue and pain, leading to malnutrition and death.
Diagnostics
Noma disease presents with underlying illnesses, systemic inflammatory response, malnutrition (usually secondary to oral incontinence), aspiration pneumonia, and septicemia may all contribute to diagnosis, however even when treated death may occur due to the acute nature of the disease (Tonna, Lewin, & Mensh, 2010). Lesion sites are tested using Koch’s Postulates by way of lab swabs, and DNA based culture testing to identify its origin and driving...

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