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Periorbital necrotising fasciitis
Davide Lazzeri1, Stefano Lazzeri, Michele Figus
1Plastic and Reconstructive Surgery Surgery Unit, Hospital of Pisa, Italy. davidelazzeri@gmail.com
The British Journal of Ophthalmology
|November 10, 2009
Summary
Periorbital necrotising fasciitis is a severe infection, often caused by Streptococcus. Early recognition and aggressive treatment are critical to prevent disfigurement, eye loss, and death.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Plastic Surgery
Background:
- Necrotising fasciitis of the periorbita is a rare but devastating infection.
- It can lead to severe disfigurement, vision loss, and mortality.
- Early diagnosis is often delayed due to non-specific initial symptoms.
Purpose of the Study:
- To systematically review published cases of periorbital necrotising fasciitis.
- To analyze clinical features, diagnoses, pathology, and management strategies.
- To identify factors influencing morbidity and mortality.
Main Methods:
- Systematic review of published literature on periorbital necrotising fasciitis.
- Inclusion of cases detailing clinical presentation, causative agents, and outcomes.
- Analysis of diagnostic and differential diagnostic approaches.
Main Results:
- The condition predominantly affects adults, with a slight female predominance.
- Common triggers include trauma and surgery, though many cases have no identified cause.
- Beta-hemolytic Streptococcus is the primary pathogen, associated with a 14.42% mortality rate, especially when alone or with Staphylococcus aureus.
Conclusions:
- Periorbital necrotising fasciitis requires prompt recognition and aggressive, multidisciplinary treatment.
- Timely surgical debridement and antibiotic therapy are crucial for improving outcomes.
- The causative organism type is a significant risk factor for mortality.
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