Periocular Necrotizing Fasciitis Causing Blindness

Modified Wound Closure Technique in Periorbital Necrotizing Fasciitis

“…Nonetheless, prior investigations have underscored the serious risk of loss of vision associated with necrotizing fasciitis. 1,4 In the current study, the overwhelming majority of patients experienced outstanding postincident visual acuities, and most were discharged from the hospital with acuities that were 20/25 or better and vision that compared favorably with that recorded on hospital admission. However, 1 patient did lose all sight, secondary to an ophthalmic artery occlusion, in keeping with previous reports of the outcomes of periorbital necrotizing fasciitis.…”

“…1 When this disorder occurs in the ocular adnexa, necrotizing fasciitis carries a substantial risk of vision loss, cosmetic deformity, and mortality. [1][2][3][4][5][6][7] While some investigations have documented excellent outcomes with exclusive medical management, 8,9 extensive debridement with adjunctive intravenous antibiotic coverage remains the mainstay of care.…”

“…1 When this disorder occurs in the ocular adnexa, necrotizing fasciitis carries a substantial risk of vision loss, cosmetic deformity, and mortality. [1][2][3][4][5][6][7] While some investigations have documented excellent outcomes with exclusive medical management, 8,9 extensive debridement with adjunctive intravenous antibiotic coverage remains the mainstay of care. [1][2][3] Borrowing from the general surgery literature, after extensive debridement, the defects associated with necrotizing fasciitis are generally covered with a sterile bandage and allowed to granulate.…”

Recurrent Necrotizing Soft Tissue Infections with Atypical Pathogens after Injection Drug Abuse: Another Manifestation of the Opioid Crisis

“…In Case 1, intra-operative cultures demonstrated infection with S. anginosus, a rare organism in NSTI although it demonstrates propensity to form abscesses in soft tissue. S. anginosus has been implicated in antecubital abscesses in injection drug users [18] and craniofacial NSTI [19][20][21]. In Case 2, the patient's intra-operative cultures showed polymicrobial normal oral flora [22], although such organisms are known to cause soft tissue infections [23].…”

Periokuläre nekrotisierende Fasziitis – Fallbericht und Überblick

“…Sobald die Diagnose der nekrotisierenden Fasziitis gestellt wurde, sollte schnellstmöglich eine chirurgische Exploration mit dem oben beschriebenen "Sondentest" durchgeführt werden, gefolgt von einem Spülen des Wundbereichs mit 1 % Wasserstoffperoxid oder einer verdünnten Povidon-Jod-Lösung und einem extensiven Débridement [21,33]. Je nachdem wie weit die Infektion fortgeschritten ist, können im Verlauf erneute chirurgische Eingriffe zum Débridement oder auch zur Exenteratio nötig werden [15,31]. Die Anwendung von hyperbarem Sauerstoff als adjuvante Therapie wird in einigen Arbeiten beschrieben, sollte aber nur zum Einsatz kommen, wenn dadurch keine Verzögerung der chirurgischen Therapie eintritt [10,16,35].…”