Cancrum nasalis, Case report: A multidisciplinary approach to management

Cancrum Nasalis, also known as nasal noma, is a variant of cancrum oris and there are very few cases reported in literature. Cancrum nasalis is a severe, gangrenous infection similar to Cancrum Oris but specifically affects the nose and surrounding facial tissues. It is characterized by rapid tissue destruction, leading to ulceration and necrosis of the nasal structures. The condition primarily affects malnourished children in developing countries, especially those with poor oral hygiene, infection and compromised immune systems. Treatment includes broad-spectrum antibiotics, wound care, nutritional support and in severe cases, reconstructive surgery to repair facial deformities. This paper reports a case of a 1 week 6 days old male who was found abandoned by a garbage dump. He was later admitted into the Special Care Baby Unit of Rivers State University Teaching Hospital and managed for neonatal sepsis, malnutrition, failure to thrive, with a necrotizing lesion on the right side of the nose. Wound swab for microscopy culture and sensitivity was done which yielded growth of Pseudomonas spp. A debridement of the necrotic lesion, with daily wound dressing done and broad spectrum antibiotics administered. The patient was discharged weeks later, however the necrotic lesion left a nasal defect. A year later, patient had a nasolabial reconstructive surgery. It is important to identify this mutilating disease as early diagnosis and intervention are crucial to improve outcomes and prevent extensive tissue loss.