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Noma in an HIV infected patient in Guinea-Bissau: a case report

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Abstract

Background

Noma is a multifactorial and multibacterial opportunistic infection that initially causes necrotic gingivitis but rapidly spreads to the nearby orofacial tissue resulting in sloughing and severe deformation of the facial structures. The majority of cases are seen in young children under the age of 6 years. Noma is strongly associated with poverty, malnutrition and immunosuppression, and is often preceded by severe systemic infections such as measles and malaria. Only few cases of noma infection in adults have been described.

Case report

We present here a case report with a 32-year-old Guinean woman who was diagnosed with noma infection and on that occasion discovered that she was HIV-1 seropositive. After treatment with amoxicillin/clavulanic acid and metronidazole for her noma infection the woman was transferred to the national hospital where antiretroviral treatment was initiated.

Conclusion

Noma is an opportunistic infection and immunodeficiencies such as HIV should always be suspected when presenting in an adult patient.

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Authors and Affiliations

  1. Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau

    Tina Madsen, Sanne Jespersen, Christian Wejse & Bo Langhoff Hønge

  2. Department of Infectious Diseases, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark

    Tina Madsen, Sanne Jespersen, Christian Wejse & Bo Langhoff Hønge

  3. National HIV Programme, Ministry of Health, Bissau, Guinea-Bissau

    Candida Medina

  4. GloHAU, Center for Global Health, School of Public Health, Aarhus University, Aarhus, Denmark

    Christian Wejse

  5. Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark

    Bo Langhoff Hønge

Authors
  1. Tina Madsen
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  2. Candida Medina
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  3. Sanne Jespersen
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  4. Christian Wejse
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  5. Bo Langhoff Hønge
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Corresponding author

Correspondence to Christian Wejse.

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The authors declare that they have no competing interest.

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Madsen, T., Medina, C., Jespersen, S. et al. Noma in an HIV infected patient in Guinea-Bissau: a case report. Infection 45, 897–901 (2017). https://doi.org/10.1007/s15010-017-1034-z

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  • DOI: https://doi.org/10.1007/s15010-017-1034-z

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