Disease bore a hole in Fuocan’s cheek
Feb 20, 2007
JOYCE Fuocan was born a normal child 12 years ago. She says a bout of malaria left her with fever blisters inside her mouth. “Others healed, but one progressed into a hole on my cheek. It was very small, but because no body cared, the wound increased.â€
By Halima Shaban
JOYCE Fuocan was born a normal child 12 years ago. She says a bout of malaria left her with fever blisters inside her mouth.
“Others healed, but one progressed into a hole on my cheek,†she said. “It was very small, but because no body cared, the wound increased.â€
Fuocan, a resident of Alyekra village in Nebbi district, said her mother abandoned her and so did her playmates. Fuocan remembers that she had to live with a hole on her right cheek for most of her childhood. That was until she was identified during a field trip by members of Uganda Society for Disabled Children (USDC) in Nebbi district and brought her to Kampala.
“Fuocan had problems eating,â€said Dr Christine Tusiime, a physiotherapist at Katalemwa Cheshire Home. “Her tongue and teeth were out and food and juice would pass through the hole and come out as she tried to chew. She could not open her jaws well.â€
Tumusiime says Fuocan was diagnosed with a congenital deformity called cancrum oris, sometimes called gangrenous stomatitis.
According to Dr Yuventine Ekoku, a principal oral surgeon at Mulago Hospital, Cancrum oris usually begins as a small wound on the firm, fleshy tissue covering the jaws and envelops the necks of the teeth (ulcer of the gingiva). The soft tissue there dies due to obstructed circulation, usually followed by decomposition of the oral and facial tissues.
This condition, mainly found in debilitated and malnourished children, is disfiguring and deadly.
Connie Tinka, the thematic director of USDC, says Fuocan was got from a caretaker. “She was staying with a Good Samaritan, who adapted her.â€
“Although this person could provide the necessities to make Fuocan feel loved and cared for, he could not afford her treatment. We took her to Nebbi Hospital, but the hospital could not handle her case,†Tinka explained.
They brought her to Katalemwa, Kampala, where she was treated for one month. She was then referred to Mengo Hospital. USDC sponsored her for an operation in Spain in December. “It was successful and Fuocan has returned to Nebbi where she is staying with her caretaker,†Tinka said.
Facts about cancrum oris
Cancrum Oris is a disorder that destroys mucous membranes of the mouth and other tissues in malnourished children.
Dr Yuventine Ekoku says it causes sudden and rapid progressive tissue destruction. The mucous membranes (gums and lining of the cheeks) become inflamed and develop ulcers.
The infection then spreads to the skin. The tissues in the lips and cheeks die due to obstructed circulation (gangrenous). Rapid, painless tissue breakdown continues and this is usually followed by decomposition of the soft tissue and bone.
Incidence
WHO estimates that 500,000 people are affected each year and 90 % of the infected children die without having received any care.
Ekoku says the condition is limited to developing countries particularly in Sub-Saharan Africa.
Causes
Although the exact cause is not known, poor hygiene and malnutrition are risk factors. Many children who develop the disease have had another illness like measles, scarlet fever, malignancy, immuno deficiency or tuberculosis. Experts also suspect bacterial infection.
Treatment
Cancrum Oris can heal without treatment if certain factors like nutrition and hygiene improve. Timely administration of antibiotics can also help.
However, it can cause massive tissue destruction before healing. Treatment with antibiotics and nutritional support halts progression of the disease. Plastic surgery may be necessary to debride destroyed tissues and reconstruct facial bones. This will improve the facial appearance.
Prevention
Measures to improve nutrition, cleanliness and sanitation may be helpful. Public health approaches such as providing a high-protein diet, clean water, and sanitation and preventing communicable diseases such as diphtheria, dysentery and tuberculosis would be needed for effective prevention of this condition in Africa.
Despite the fact that more than 400,000 children are affected in Africa alone, there is only one cancrum oris hospital, Noma Children Hospital Sokoto, located in Nigeria. European and American medical teams travel there to perform operations and plastic surgery.
JOYCE Fuocan was born a normal child 12 years ago. She says a bout of malaria left her with fever blisters inside her mouth.
“Others healed, but one progressed into a hole on my cheek,†she said. “It was very small, but because no body cared, the wound increased.â€
Fuocan, a resident of Alyekra village in Nebbi district, said her mother abandoned her and so did her playmates. Fuocan remembers that she had to live with a hole on her right cheek for most of her childhood. That was until she was identified during a field trip by members of Uganda Society for Disabled Children (USDC) in Nebbi district and brought her to Kampala.
“Fuocan had problems eating,â€said Dr Christine Tusiime, a physiotherapist at Katalemwa Cheshire Home. “Her tongue and teeth were out and food and juice would pass through the hole and come out as she tried to chew. She could not open her jaws well.â€
Tumusiime says Fuocan was diagnosed with a congenital deformity called cancrum oris, sometimes called gangrenous stomatitis.
According to Dr Yuventine Ekoku, a principal oral surgeon at Mulago Hospital, Cancrum oris usually begins as a small wound on the firm, fleshy tissue covering the jaws and envelops the necks of the teeth (ulcer of the gingiva). The soft tissue there dies due to obstructed circulation, usually followed by decomposition of the oral and facial tissues.
This condition, mainly found in debilitated and malnourished children, is disfiguring and deadly.
Connie Tinka, the thematic director of USDC, says Fuocan was got from a caretaker. “She was staying with a Good Samaritan, who adapted her.â€
“Although this person could provide the necessities to make Fuocan feel loved and cared for, he could not afford her treatment. We took her to Nebbi Hospital, but the hospital could not handle her case,†Tinka explained.
They brought her to Katalemwa, Kampala, where she was treated for one month. She was then referred to Mengo Hospital. USDC sponsored her for an operation in Spain in December. “It was successful and Fuocan has returned to Nebbi where she is staying with her caretaker,†Tinka said.
Facts about cancrum oris
Cancrum Oris is a disorder that destroys mucous membranes of the mouth and other tissues in malnourished children.
Dr Yuventine Ekoku says it causes sudden and rapid progressive tissue destruction. The mucous membranes (gums and lining of the cheeks) become inflamed and develop ulcers.
The infection then spreads to the skin. The tissues in the lips and cheeks die due to obstructed circulation (gangrenous). Rapid, painless tissue breakdown continues and this is usually followed by decomposition of the soft tissue and bone.
Incidence
WHO estimates that 500,000 people are affected each year and 90 % of the infected children die without having received any care.
Ekoku says the condition is limited to developing countries particularly in Sub-Saharan Africa.
Causes
Although the exact cause is not known, poor hygiene and malnutrition are risk factors. Many children who develop the disease have had another illness like measles, scarlet fever, malignancy, immuno deficiency or tuberculosis. Experts also suspect bacterial infection.
Treatment
Cancrum Oris can heal without treatment if certain factors like nutrition and hygiene improve. Timely administration of antibiotics can also help.
However, it can cause massive tissue destruction before healing. Treatment with antibiotics and nutritional support halts progression of the disease. Plastic surgery may be necessary to debride destroyed tissues and reconstruct facial bones. This will improve the facial appearance.
Prevention
Measures to improve nutrition, cleanliness and sanitation may be helpful. Public health approaches such as providing a high-protein diet, clean water, and sanitation and preventing communicable diseases such as diphtheria, dysentery and tuberculosis would be needed for effective prevention of this condition in Africa.
Despite the fact that more than 400,000 children are affected in Africa alone, there is only one cancrum oris hospital, Noma Children Hospital Sokoto, located in Nigeria. European and American medical teams travel there to perform operations and plastic surgery.