Posttraumatic periorbital necrotizing fasciitis

Abstract

Purpose To present the case report of a patient who developed periorbital necrotizing fasciitis following trauma with favorable response. Methods 73 year‐old‐female came to the emergency department after downfall with a trauma in facial region. At the initial examination the patient had a large eyelid swelling in both eyes and a wound that required stitches on the left superciliary region. 5 days later the patient presented to our clinic with general discomfort, fever of 39°C and with slurring, crusty necrotic in the right eyelid, redness and heat in both upper eyelids and in frontal area. Results Because of clinical suspicion of periorbital necrotizing fasciitis, we performed a debridement of the wound in the right upper eyelid, draining the purulent in frontal area, sampling for culture and intravenous treatment with amoxicillin‐clavulanate. In the culture Steptococcus pyogenes isolates. After 15 days of intravenous antibiotic treatment and local cures, the patient was discharged from hospital. One month later, the patient had complete resolution of the lesions with a mild ptosis in the right eye. Conclusion Although this is a disease with a low incidence, it has a high morbidity and mortality if appropriate treatment is not performed. Treatment consists in an immediate and extensive debridement of the affected area with broad‐spectrum antibiotic.