Periorbital necrotizing fasciitis induced by streptococcus pyogenes: a case report and clarification.

Publication date: Available online 11 September 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): D. Deneubourg, Z. Catherine, P. Lejuste, P. Breton
IntroductionPeriorbital necrotizing fasciitis (PONF) is a rare condition of the face. PONF can lead to blindness, functionnal and aesthetic sequellae, multiple organ failure and death. The aim of this article is, through a case report, to raise the awereness of maxillofacial surgeons on this severe disease.Case reportWe report a case of a 30-year-old woman who presented with a bilateral palpebral oedema and pain three days after a jugal wound was sutured. Necrosis of the skin of the left palpebral unit was extending rapidly. The patient had signs of sepsis. Surgical debridement was performed promptly and associated with intravenous broad-spectrum empiric antibiotics. The patient recovered slowly with no complication other than residual skin defect of both eyelids which was later corrected by fullthickness skin graft.ConclusionSpecial attention should be payed to signs of preseptal cellulitis as they can, in some cases, rapidly turn into a PONF. Early diagnosis and treatment are the keys to favorable outcome.



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