J Korean Ophthalmol Soc.  2004 Jan;45(1):135-140.

A Case of Eyelid Necrosis and Periorbital Necrotizing Fasciitis

• Kim SY
• Choi JH
• Moon SH
• Chang YH
• Jang JW

Abstract

PURPOSE
Necrotizing fasciitis is an uncommon soft tissue infection which spreads rapidly along subcutaneous fascial planes and produces overlying skin necrosis. We report a case of eyelid necrosis and periorbital necrotizing fasciitis. METHODS: A 64-year-old, previously healthy, male visited the emergency room complaining of acute facial edema. He had been using an ointment for itchy scalp lesion due to hair dye, and had multiple mosquito bites on his forehead. He took NSAIDs before the day of visit for headache. Physical examination showed erythematous swelling of soft tissue and tense fluctuant bullae on eyelid and periorbital area. On the 6th day of hospitalization bullae ruptured, and purplish discoloration and necrosis were noticed. RESULTS: Parenteral antibiotics and surgical debridement were applied. Wound cultures were positive for Staphylococcus aureus resistant to methicillin. Histology of the debrided tissue showed necrotizing inflammation. The full-thickness skin graft was performed over the exposed pretarsal and preseptal orbicularis muscle of the right eyelid. The skin defects were healed with the recovery of adequate eyelid function. CONCLUSIONS: We achieved satisfactory results with proper diagnosis and management such as parenteral antibiotics and surgical debridement in a case with eyelid and periorbital necrotizing fasciitis.

Keyword

Eyelid necrosis; Necrotizing fasciitis

MeSH Terms

Anti-Bacterial Agents
Anti-Inflammatory Agents, Non-Steroidal
Culicidae
Debridement
Diagnosis
Edema
Emergency Service, Hospital
Eyelids*
Fasciitis, Necrotizing*
Forehead
Hair
Headache
Hospitalization
Humans
Inflammation
Male
Methicillin
Middle Aged
Necrosis*
Physical Examination
Scalp
Skin
Soft Tissue Infections
Staphylococcus aureus
Transcutaneous Electric Nerve Stimulation
Transplants
Wounds and Injuries
Anti-Bacterial Agents
Anti-Inflammatory Agents, Non-Steroidal
Methicillin