Periorbital necrotizing fasciitis

Abstract

Necrotizing Fasciitis is a rare, rapidly progressing and severe infection of subcutaneous tissue and underlying fascia. Thrombosis of perforating vessels of the skin and subcutaneous tissue is the characteristic pathological feature. The disease can be monomicrobial or polymicrobial in origin. However, Poly microbial source of infection is more common. Typical sites of infection include extremities, abdomen and perineum. High index of suspicion is essential to prompt early diagnosis and ensure a favorable outcome. Management necessitates immediate surgical and antimicrobial treatment. This case report describes the rare presentation of periorbital necrotizing fasciitis. However, it highlights the key features of the disease for example rapid progression and extension, severe pain, systemic toxicity and subcutaneous tissue necrosis. HIV infection was the risk factor whereas Streptococcus pyogenes and Staphylococcus aureus were the causative organisms. Prompt diagnosis, early surgical intervention and administration of intravenous broad spectrum antibiotics resulted in encouragable recovery.