Periorbital Necrotizing Fasciitis

Elwood, Eric T.; Sommerville, Drew N.; Murray, John D.

doi:10.1097/01.prs.0000287274.57709.d5

Cited by 11 publications

(9 citation statements)

References 16 publications

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“…Although there are known risk factors (table 2), mainly related to mild (alcoholism,6 17 20 23 26 29 32 35 36 44 45 52 53 55 64 70 diabetes,6 10 11 15 22 50 51 58 68 rheumatological disease,18 45 48 chronic corticosteroid use and a combination of these conditions25 40 55) and severe (chemotherapy for malignancies and lymphoproliferative disorders)28 41 48 62 67 immune suppression, about one-half of the patients with reported NF were previously healthy 4 6–8 12 13 16 19 21 23 24 27 30–35 37–39 41–43 45–47 49 54–57 60 63 66 69 72–74. Haematological malignancy itself (our case) and neutropenia caused by chemotherapy may be an important predisposing factor for NF, because of the reduction in the number and activity of effector cells such as neutrophils and monocytes, and disruption of the barrier function of mucosal membranes.…”

Section: Resultsmentioning

confidence: 99%

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Periorbital necrotising fasciitis

Lazzeri

Figus

et al. 2009

British Journal of Ophthalmology

109

141

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Necrotising fasciitis involving the periorbita is a devastating infection. Potential outcomes range from severe disfigurement, loss of the eye and even to death. Early recognition is critical, although its initially non-distinctive appearance frequently delays diagnosis and treatment. Herein, the authors have performed a systematic review of previously published cases including clinical features, diagnoses and differential diagnoses, pathological characteristics and management. Periorbital necrotising fasciitis is seen mainly in adults with a female predominance (54%); about one-half (47%) of the patients were previously healthy. The infection can follow local blunt trauma (17%), penetrating injuries (22%) and face surgery (11%), but in about one-third of cases (28%) no cause was identified. Non-specific erythema and localised painful swelling of the eyelids characterise the earliest manifestation of the disease, followed by formation of blisters and necrosis of the periorbital skin and subcutaneous tissues. The causative organism in periorbital infection was mainly β-haemolytic Streptococcus alone (50%), occasionally in combination with Staphylococcus aureus (18%). The overall mortality rate was 14.42%. The main risk factor for mortality was the type of causative organism, since all reported cases of death were caused by β-haemolytic Streptococcus alone or associated with other organisms. Unlike necrotising fasciitis affecting other body sites, there was not a strong correlation with age >50 years or the presence of associated chronic illness. Management of periorbital necrotising fasciitis is then based on early distinction of symptoms and signs and aggressive multidisciplinary treatment. Thus, the delay between initial debridement and initiating parenteral broad-spectrum antibiotic therapy should be considered the most critical factor influencing morbidity and mortality.

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Section: Resultsmentioning

confidence: 99%

“…Rare causative agents include S. aureus alone,12 59 66 68 72 Pseudomonas aeruginosa ,62 67 Moraxella catarrhalis 65 and Cryptococcus neoformans 4 mainly in the setting of immunosuppression. Groups of Gram-positive aerobes or mixed Gram-positive and Gram-negative aerobes were also cultured 6 7 13 23 29–31 34 42 43 55 58 60…”

Section: Resultsmentioning

confidence: 99%

Periorbital necrotising fasciitis

Lazzeri

Figus

et al. 2009

British Journal of Ophthalmology

109

141

View full text Add to dashboard Cite

show abstract

“…We have recently managed (Lazzeri et al, 2009) a new case of periorbital NF caused by P. aeruginosa that needs to be added to two previously reported cases (Poitelea and Wearne, 2005;Elwood et al. 2007) (Table 1).…”

Section: To the Editorsmentioning

confidence: 91%

“…Haematological malignancies themselves (Lazzeri et al, 2009;Poitelea and Wearne, 2005) as well as neutropaenia induced by HIV (Scheepers et al, 2010), systemic disorders (Ganesh et al, 2007), malnutrition (Prendiville and Bath, 1988), and sepsis and chemotherapy (Steinkogler et al, 1985;Elwood et al; may be in this way an important predisposing factor for infections by reducing number and activity of effector cells like neutrophils and monocytes, and by disrupting the barrier function of the mucosal membrane.…”

Section: To the Editorsmentioning

confidence: 97%