Pathophysiological Considerations in Periorbital Necrotizing Fasciitis: A Case Report

Hadizamani, Yalda; Anastasi, Stefano; Schori, Anouk; Lucas, Rudolf; Garweg, Justus G.; Hamacher, Jürg

doi:10.1080/09273948.2022.2032190

Cited by 5 publications

(2 citation statements)

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“…The overall incidence of NF is estimated to be approximately 3.5 cases per 100,000 individuals [3]. The mortality rate associated with NF ranges from 10% to 40%, but, without prompt medical or surgical intervention, it can rise to as high as 80% [3][4][5][6]. While NF typically affects the extremities, abdominal wall, and perineum, cervico-facial involvement is exceptionally rare [1,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Among the precipitating events, odontogenic infections are the most commonly associated cause, and Group A Streptococcus is the predominant infectious agent [3]. The pathogenesis of NF is characterized by the invasion of bacteria into the subcutaneous tissues, rapid horizontal spread of infection along the deep fascial planes, and release of bacterial toxins, leading to tissue ischemia and liquefactive necrosis [5,6,9,10].…”

Section: Introductionmentioning

confidence: 99%

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Periorbital Facial Necrotizing Fasciitis in Adults: A Rare Severe Disease with Complex Diagnosis and Surgical Treatment—A New Case Report and Systematic Review

Pertea,

Fotea,

Luca

et al. 2023

JPM

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(1) Background: Necrotizing fasciitis (NF) is a severe and aggressive pathology with a rapid progression and high mortality risk. Periocular NF is a rare condition associated with a lower mortality risk but significantly higher disabling sequelae. (2) Methods: We present the case of a 67-year-old homeless patient, a victim of assault, with multiple untreated comorbidities (diabetes mellitus, cardiac conditions, and schizophrenia) and a delayed diagnosis of periocular necrotizing fasciitis. The condition showed a cyclical evolution influenced by the existing comorbidities, and the patient underwent both surgical and medical treatment with a multidisciplinary team. Additionally, we report a systematic review of cases from the literature. (3) Results: The patient’s survival outcomes were favorable; however, the sequelae were disabling, not only concerning aesthetic aspects but also due to the loss of the affected eye globe. The systematic review revealed the rarity of such cases and the peculiarities of the presented case compared to those reported in the literature up to this point. (4) Conclusions: Understanding the signs, symptoms, and predisposing factors, as well as the potential rare localizations of NF, including the periocular region, can lead to the early diagnosis and treatment with good functional and aesthetic outcomes, minimizing significant disabilities.

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