Noma: A disease of poverty presenting at an urban hospital in the United States

HSV: Herpes simplex virus INTRODUCTION Noma, also known as cancrum oris or the face of poverty, is a rapidly progressive polymicrobial opportunistic infection resulting in orofacial gangrene and eventually death if untreated. The etiopathogenesis of the disease has been attributed to extreme malnutrition, dehydration, and inadequate oral hygiene. Noma is primarily observed among children younger than 6 years in countries with a low human development index, with the highest incidence occurring in the noma belt, which extends from sub-Saharan West Africa to central Sudan. Cases in adults and citizens of high income countries are exceedingly rare and have been limited to those with immunodysfunction. We report a case of noma in an immunocompetent man who presented to an urban hospital in the United States.