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Noma Management in a Child With Systemic Lupus Erythematosus
Bnckurmmd: N()///(J. also known CH {'(lIIC/HlII oris. i.; (111 (.,.(!/acia/ Xl1lJ.!,:rt:'Ilt:, )1'hich dltrillK irs./il/lllill(lliIlX stage CUlI.It'S progr';.I,III'e ami 111111 ilu! illg de,lf ruction (~llhl! ill(t!( 'led li.I,1 /{t! I_ The di \1!(1S(~ (/( 'ell rs mui nlv ill child reil 1\ i lh malnut rition. floor oral hygiene and dehililol ill\!. C(JI/ClI!Tt'1I1I/lI/t!SS_ Purpose: TIlt' ann (!trll/.I /)lll)t/rlj"(H 10 report a unique CllSf! (!(IIOII/U associated with systemic lupus elTlhellllllo,\I/S ill WI i\•.\'/'ur-o/d hov. Cuse: All X-yeor-old !Joy referred III Ora/ Medicine Department ccnnpiaining about an utcer cu the It'ji coma (!1 his mcnult tcn: I month, l)(JiI!/iil and (I(fticlllfy ill oj)t'llin,l{ lhl' mouth. The patient 11 '(IS diagnosed svstanic IIIIW.\" ervthematosus sincl:' 1-1 monthl heJi)/'t' and had been ;.:il•t'1I /mll/l/l/(I_llIjiprt'.I"sil't' lh(!I"(JI!Y. The patient )I'us also diagnosed severe malnutrition. Hal:'llwIII/o;.:ic il/I't',lfiguliO//_\ rt'I't'alt:'J anrmiu. Ca s l•l1wIWj.!{•l11l'111_• Pannronnc radioxraphy \I'as twrjonned 10 check/or dental or Ih'rioc/oll/u/.Ii}(;i /!I illli'cli"II. hili }/(! ahllll),III11lilil:'.1 )I','re f!rdt'lIl. The lliic,."II/,'/Og_l• exalllinuli,,,, revetaed FlIsohacteriulIllleCnl!)/wl"lI!11. Staphvlococcns lI(1n:II,I, and Ktobsietla. TIlt' patient 11,1,1 been treated \\ ifll ora/ irnganan IIsillg liye/rogl:!ll peroxide. saline and 0.2% chtorhesidine. Ih/{s hlC"il'ed to ,Ilough the necrotic flSSlle_ Oral Llllllhiolics and ,II/algesic.l" \\'ert' prescribed. The patient was admitted to hospitot under the care ot a 1)lC"dia,r.iciall. allergy ~'d i1ll1l11l1/0/0gy ,111t:'ciafi,lf, and a nutritionist. The result (~rlhe c:)/nl)r~~lellsi\'(: disease II/wwgemellt sl/Ou'eel that fhe le.IJI/II IIl!afed c/)/IIp/t!lefy. hI/I i(!OIlIIg a scar (/)/ IllS comeI' I~I {ht' mauth; Ifs ptvysical effects are permanent and IIIUY rer/lllre reconsiructive surgery to he repaired hy I)ra/ surgeon. Conclusion: /\.'(1/1W is I/Of a nnmarv disease. there are various l)redi,\lWsillg tacturs /I.wuily precedeits occurrellce, Tilt' 1I/(Jllllgl'IIIt'1I1 0(11011/(/ rt'(jllirn' a /lllIffldisciplinary approach.
Key words: Noma, svstcrnic: lupus en•flU:lllalo,IIl.I', mal nutritian, I!Irlllllt;elllel/[
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