title: Acute necrotic stomatitis (noma) associated with methicillin-resistant Staphylococcus aureus infection in a newly acquired rhesus macaque (Macaca mulatta).
abstract: BACKGROUND
  A newly acquired rhesus macaque was suffering from rapid destruction of the left cheek caused by necrotizing stomatitis.
  
  
  METHODS
  To restore reconstructive surgery and intensive care with antibiotics, wound protection, wound healing agents, and debridement were applied.
  
  
  RESULTS
  Staphylococcus aureus and Enterococcus faecalis were isolated from the culture of the lesion, and the antibiotic susceptibility test revealed methicillin-resistant Staphylococcus aureus infection. Vancomycin and ampicillin-sulbactam effectively treated the bacterial infections, and reconstructive surgery was performed once the infection was cleared. Topical application of recombinant human epidermal growth factor (rhEGF) was useful to treat exposed wound of the noma lesion.
  
  
  CONCLUSIONS
  Simian noma associated with methicillin-resistant Staphylococcus aureus (MRSA) had not previously been reported in non-human primates. Although noma associated with MRSA is hard to cure because of its rapid and destructive progress, the aggressive therapy used in this study led to the successful resolution of an acute necrotic stomatitis lesion in a rhesus macaque.
authors.affiliation: Xenotransplantation Research Center, Seoul National University Hospital, Seoul, South Korea.
authors.forename: J-I
authors.initials: JI
authors.lastname: Lee
authors.forename: K-S
authors.initials: KS
authors.lastname: Kim
authors.forename: B-C
authors.initials: BC
authors.lastname: Oh
authors.forename: N-A
authors.initials: NA
authors.lastname: Kim
authors.forename: I-H
authors.initials: IH
authors.lastname: Kim
authors.forename: C-G
authors.initials: CG
authors.lastname: Park
authors.forename: S-J
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000667:Ampicillin / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D013293:Enterococcus faecalis / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D004815:Epidermal Growth Factor / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D008253:Macaca mulatta; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D008992:Monkey Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D009055:Mouth / Q000473:pathology / Q000601:surgery; D009336:Necrosis / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000662:veterinary; D009625:Noma / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000662:veterinary*; D019647:Oral Surgical Procedures / Q000662:veterinary; D019651:Plastic Surgery Procedures / Q000662:veterinary; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000662:veterinary*; D013280:Stomatitis / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery / Q000662:veterinary; D013407:Sulbactam / Q000627:therapeutic use; D014640:Vancomycin / Q000627:therapeutic use; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents; D004815:Epidermal Growth Factor; C035444:sultamicillin; D014640:Vancomycin; D000667:Ampicillin; D013407:Sulbactam