Bilateral Periorbital Necrotizing Fasciitis

Jensen, Sarah L.; Amato, Josh E.; Hartstein, Morris E.; Breer, Wayne A.

doi:10.1001/archderm.140.6.664

Cited by 21 publications

(10 citation statements)

References 11 publications

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“…Although there are known risk factors (table 2), mainly related to mild (alcoholism,6 17 20 23 26 29 32 35 36 44 45 52 53 55 64 70 diabetes,6 10 11 15 22 50 51 58 68 rheumatological disease,18 45 48 chronic corticosteroid use and a combination of these conditions25 40 55) and severe (chemotherapy for malignancies and lymphoproliferative disorders)28 41 48 62 67 immune suppression, about one-half of the patients with reported NF were previously healthy 4 6–8 12 13 16 19 21 23 24 27 30–35 37–39 41–43 45–47 49 54–57 60 63 66 69 72–74. Haematological malignancy itself (our case) and neutropenia caused by chemotherapy may be an important predisposing factor for NF, because of the reduction in the number and activity of effector cells such as neutrophils and monocytes, and disruption of the barrier function of mucosal membranes.…”

Section: Resultsmentioning

confidence: 99%

“…Unlike NF of the extremities and trunk where cultures are polymicrobial, the causative organism in periorbital infection (table 2) appears to be β-haemolytic Streptococcus7 10 11 14–16 19 20 23 24 26–28 31–35 37 39–42 45 47 48 51–53 55 56 61 63 70 73 74 (mainly S. Pyogenes ) alone but occasionally in combination with S. aureus 7 17 18 25 32 35 38 44–46 49 50 54 55 57 64. Rare causative agents include S. aureus alone,12 59 66 68 72 Pseudomonas aeruginosa ,62 67 Moraxella catarrhalis 65 and Cryptococcus neoformans 4 mainly in the setting of immunosuppression.…”

Section: Resultsmentioning

confidence: 99%

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Periorbital necrotising fasciitis

Lazzeri

Figus

et al. 2009

British Journal of Ophthalmology

100

141

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Necrotising fasciitis involving the periorbita is a devastating infection. Potential outcomes range from severe disfigurement, loss of the eye and even to death. Early recognition is critical, although its initially non-distinctive appearance frequently delays diagnosis and treatment. Herein, the authors have performed a systematic review of previously published cases including clinical features, diagnoses and differential diagnoses, pathological characteristics and management. Periorbital necrotising fasciitis is seen mainly in adults with a female predominance (54%); about one-half (47%) of the patients were previously healthy. The infection can follow local blunt trauma (17%), penetrating injuries (22%) and face surgery (11%), but in about one-third of cases (28%) no cause was identified. Non-specific erythema and localised painful swelling of the eyelids characterise the earliest manifestation of the disease, followed by formation of blisters and necrosis of the periorbital skin and subcutaneous tissues. The causative organism in periorbital infection was mainly β-haemolytic Streptococcus alone (50%), occasionally in combination with Staphylococcus aureus (18%). The overall mortality rate was 14.42%. The main risk factor for mortality was the type of causative organism, since all reported cases of death were caused by β-haemolytic Streptococcus alone or associated with other organisms. Unlike necrotising fasciitis affecting other body sites, there was not a strong correlation with age >50 years or the presence of associated chronic illness. Management of periorbital necrotising fasciitis is then based on early distinction of symptoms and signs and aggressive multidisciplinary treatment. Thus, the delay between initial debridement and initiating parenteral broad-spectrum antibiotic therapy should be considered the most critical factor influencing morbidity and mortality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Periorbital necrotising fasciitis

Lazzeri

Figus

et al. 2009

British Journal of Ophthalmology

100

141

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“…[2][3][4][5][6][7]12 To date, these debridements have generally necessitated wide excision of necrotic tissue, leaving an open wound that is traditionally packed with a wound dressing. This report documents a novel wound closure technique in cases of periorbital necrotizing fasciitis and represents the first description of direct closure of the skin that overlies the underlying debrided planes.…”

Section: Discussionmentioning

confidence: 99%

“…1 When this disorder occurs in the ocular adnexa, necrotizing fasciitis carries a substantial risk of vision loss, cosmetic deformity, and mortality. [1][2][3][4][5][6][7] While some investigations have documented excellent outcomes with exclusive medical management, 8,9 extensive debridement with adjunctive intravenous antibiotic coverage remains the mainstay of care. [1][2][3] Borrowing from the general surgery literature, after extensive debridement, the defects associated with necrotizing fasciitis are generally covered with a sterile bandage and allowed to granulate.…”

mentioning

confidence: 99%

Modified Wound Closure Technique in Periorbital Necrotizing Fasciitis

Wladis¹

2015

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Generally face/neck NF has been described as a consequence of dental, oral, or eye lesions. 12,14 Antibiotic choice is a key factor in the treatment of NF. 9,16 Streptococci are normally highly sensitive to penicillin.…”

mentioning

confidence: 99%

Fatal Necrotizing Fasciitis and Myositis in a Captive Common Bottlenose Dolphin (Tursiops Truncatus) Associated with Streptococcus Agalactiae

Zappulli¹,

Mazzariol²,

Cavicchioli³

et al. 2005

J VET Diagn Invest

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Abstract.A common bottlenose dolphin (Tursiops truncatus) was presented for necropsy after acute onset of gastrointestinal signs and cutaneous lesions that rapidly progressed to death. Gross and microscopic findings were characterized by locally extensive severe necrohemorrhagic fasciitis and cellulitis, and severe necrotizing myositis in the head and dorsocranial thorax, with numerous disseminated gram-positive cocci. Streptococcus agalactiae was isolated from the lesions and from visceral organs (liver and lung), and it was identified by standard microbiology techniques. This communication is the first report of necrotizing fasciitis in a marine mammal associated with S. agalactiae.

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Bilateral Periorbital Necrotizing Fasciitis

Cited by 21 publications

References 11 publications

Periorbital necrotising fasciitis

Periorbital necrotising fasciitis

Modified Wound Closure Technique in Periorbital Necrotizing Fasciitis

Fatal Necrotizing Fasciitis and Myositis in a Captive Common Bottlenose Dolphin (Tursiops Truncatus) Associated with Streptococcus Agalactiae

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