Rationale: Cancrum oris, also known as noma, is a rare and rapidly progressing gangrenous infection affecting the oral cavity, commonly seen in malnourished children. We discuss the clinical presentation, diagnostic dilemma and management in a 54-year-old male human immunodeficiency virus-positive patient with oral ulceration clinically resembling squamous cell carcinoma (SCC).
Patient concerns: The patient had severe oral ulceration with pain and difficulty eating food.
Diagnosis: Histopathological examination was misleading as it revealed features akin to early invasion of SCC. Immunohistochemistry findings were not in favour of SCC.
Treatment: Antiretroviral therapy was started owing to the decreased CD4 cell count.
Outcomes: Lesions began to show signs of healing on follow-up.
Take-away lessons: This case aims to highlight the unique challenges of diagnosing and emphasises the importance of considering opportunistic infections in immunocompromised patients presenting with oral ulcerations to prevent misdiagnosis and maltreatment.
Keywords: Acute immunodeficiency syndrome; antiretroviral therapy; cancrum oris; noma; squamous cell carcinoma.
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