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Postoperative infection with group A beta-hemolytic Streptococcus after blepharoplasty
1Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, School of Medicine, Los Angeles, California 90095-7000, USA.
American Journal of Ophthalmology
|December 10, 2002
Summary
A rare case of early necrotizing fasciitis caused by group A beta-hemolytic Streptococcus occurred after cosmetic blepharoplasty. Prompt treatment with antibiotics and supportive care led to recovery with minimal scarring.
Area of Science:
- Ophthalmology
- Infectious Disease
- Plastic Surgery
Background:
- Cosmetic blepharoplasty is a common procedure, but carries a risk of post-operative infection.
- Group A beta-hemolytic Streptococcus (GABHS) can cause severe soft tissue infections.
Observation:
- A healthy 59-year-old woman developed rapid onset of severe pain, edema, and a bulla in the left eyelid 30 hours after blepharoplasty and midface lift.
- Cultures from eyelid exudates identified GABHS.
Findings:
- The patient received intravenous antibiotics, corticosteroids, hyperbaric oxygen, and surgical debridement.
- The infection resolved with minimal scarring of the left upper eyelid.
Implications:
- GABHS infections can occur after surgery in highly vascularized facial areas.
- Early recognition and aggressive multimodal treatment are crucial for managing this potentially devastating infection, especially in immunocompromised or vascularly compromised patients.