{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:10:01Z","timestamp":1756361401713,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,12,4]]},"abstract":"<jats:p>A 2-year-6-month old, appropriately immunised, well-thriving boy, symptomatic for the past 6\u2005months, presented with recurrent fever, progressive pallor, lymphadenopathy and a raw area on the right cheek, with discharging sinus. The necrotising infection of the face developed after one and half months of febrile illness. This febrile illness with bicytopaenia was diagnosed as enteric fever and treated with antibiotics. Skin grafting was performed for the full-thickness defect of the face. The patient continued to have a non-healing oral ulcer with progressive pallor and was finally diagnosed as having acute lymphoblastic leukaemia. Immunodeficiency was ruled out by appropriate investigations. Noma is an indirect measure of extreme poverty, but malignancy is known to predispose to this debilitating condition. The worldwide incidence of Noma is reported to be 30\u2005000\u2013140\u2005000, with a preponderance in sub-Saharan Africa. This case emphasises the need for a thorough search for the underlying illness predisposing to a rare opportunistic infection such as Noma in a well-thriving child.<\/jats:p>","DOI":"10.1136\/bcr-2015-211674","type":"journal-article","created":{"date-parts":[[2016,2,14]],"date-time":"2016-02-14T20:48:04Z","timestamp":1455482884000},"page":"bcr2015211674","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Noma in a child with acute leukaemia: when the \u2018face of poverty\u2019 finds an ally"],"prefix":"10.1136","volume":"2016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4440-5339","authenticated-orcid":false,"given":"Amitabh","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anirban","family":"Mandal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachna","family":"Seth","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sushil Kumar","family":"Kabra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,1,6]]},"reference":[{"key":"2025082722351524000_2016.jan06_1.bcr2015211674.1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.1997.d01-220.x"},{"key":"2025082722351524000_2016.jan06_1.bcr2015211674.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69004-1"},{"key":"2025082722351524000_2016.jan06_1.bcr2015211674.3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.2003.01036.x"},{"key":"2025082722351524000_2016.jan06_1.bcr2015211674.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60549-1"},{"key":"2025082722351524000_2016.jan06_1.bcr2015211674.5","doi-asserted-by":"crossref","first-page":"223","DOI":"10.4269\/ajtmh.1999.60.223","article-title":"Pathogenesis of Cancrum Oris (Noma): confounding interactions of malnutrition with infection","volume":"60","author":"Enwonwu","year":"1999","journal-title":"Am J Trop Med Hyg"},{"key":"2025082722351524000_2016.jan06_1.bcr2015211674.6","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(74)90305-3"},{"key":"2025082722351524000_2016.jan06_1.bcr2015211674.7","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(76)90250-4"},{"key":"2025082722351524000_2016.jan06_1.bcr2015211674.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.1983.tb00267.x"},{"key":"2025082722351524000_2016.jan06_1.bcr2015211674.9","first-page":"33","article-title":"Cancrum Oris (Noma) in a patient with acute lymphoblastic leukaemia. 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