Incidence of periorbital necrotising fasciitis in the UK population: a BOSU study

Abstract

PNF is a rare, dangerous condition. This study identified an incidence of 0.24 per 1,000,000 per annum in the UK. β-haemolytic Streptococcus A is the most common causative organism. Mortality remains a potential outcome, and survivors suffer significant morbidity. Early intravenous antibiotic management with a consensus favouring penicillin and clindamycin combined with debridement.

Periocular necrotising fasciitis: a multicentre case series

“…One of 29 (3%) of our patients died and 6/29 (21%) developed systemic shock, as compared with an amputation risk of 16%, septic shock risk of 40% and a mortality of 22% (up to 67% in one study) for disease elsewhere 1 14–16. Systemic NF often requires at least 5 sessions of debridement to control and up to 33 sessions have been reported 17.…”

“…It is possible the rates of Type 1 disease might be overestimated, as large areas of necrotic tissue would reasonably be expected to become rapidly populated by a wide spectrum of aerobic and anaerobic bacteria. GAS have a range of molecules that confer infective advantages, including surface M proteins that suppress neutrophil phagocytosis, and exotoxins A and B that stimulate cytokine release causing shock, organ failure and immune suppression 1 14. All but four of our series had GAS isolated.…”

“…Periocular necrotising fasciitis (PONF) is rare, with a recent study estimating a UK incidence of 0.24 cases per million per annum 1. Most experience of PONF, based on case reports and three small case series,2–11 indicates that PONF has a better prognosis than the condition elsewhere in the body, and there are reports of success with medical treatment alone 12 13.…”

Periorbital Necrotizing Fasciitis Caused by Streptococcus Viridians

“…β hemolytic Streptococcus A was identified in 76% and systemic complications in 66.66% with sepsis and death occurred in 10% [14].…”

A Necrotized Eyelid

“…PNF is extremely rare with an incidence rate of less than 1 per million per year (1). Group A β-hemolytic Streptococcus is the most common pathogen and complication of toxic shock syndrome is frequently observed (1,2). Although the mortality of PNF is relatively low (approximately 10%) compared to that occurring in the extremities, the infection can result in blindness and cosmetic issues.…”