Periorbital necrotising fasciitis after minor trauma

Abstract

Physicians and ophthalmologists must be aware of the risk factors, although rare, for periorbital necrotising fasciitis and the cardinal signs that differentiate this condition from common non-necrotising preseptal cellulitis. Prompt recognition and early surgical debridement are crucial in limiting the morbidity and mortality from severe forms of this disease.

Periorbital necrotising fasciitis

“…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.…”

“…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. The infection may follow (table 2) local blunt trauma,6 14 15 17 21 27 29 30 33 34 42 49 53 55 57 73 or any condition in which the integrity of eyelid integument is compromised by abrasion, laceration or penetrating injuries 4 6–8 11 20 23–26 31 32 35–37 45 55 58 64 74. NF has also been reported following blepharoplasty,43 47 51 56 dacryocystorhinostomy,48 surgical biopsy and excision,12 28 35 42 61 69 and self-puncture of a hordeolum externum.…”

Periorbital necrotising fasciitis: delay in diagnosis results in loss of lower eyelid

“…Facial involvement is rare owing to the excellent blood supply of this region [1] and is often not recognised in the early stages. However, the most common site of NF in the face is the periorbital region [2].…”

Fascitis necrosante palpebral y shock tóxico por Streptococcus pyogenes

“…Como en el presente reporte, la aparición de FN palpebral ha sido descrita después de un trauma o de una abrasión menor. Además se ha observado secundariamente a picaduras de insecto, infecciones respiratorias altas o con posterioridad a procedimientos como dacrio-cisto-rinostomía o blefaroplastía por lá-ser o quirúrgica [5][6][7][8] . Una comunicación reciente advierte sobre la aparición tardía de FN palpebral en pacientes en los que se ha realizado una rinoplastía utilizando una prótesis de silicona 9 .…”