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Periocular necrotising fasciitis: a multicentre case series
Saul N Rajak1,2,3, Edwin C Figueira3, Anjana S Haridas4
1Adnexal, Moorfields Eye Hospital, London, UK.
The British Journal of Ophthalmology
|February 4, 2016
Summary
Necrotising fasciitis (NF) of the eye is rare but serious. This study found PONF has a better prognosis than elsewhere, but risks visual loss and death. Antibiotics with careful monitoring may suit some patients.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Surgery
Background:
- Necrotising fasciitis (NF) is a severe, life-threatening soft tissue infection.
- Periocular necrotising fasciitis (PONF) is an extremely rare manifestation of NF.
- Limited data exists on PONF's clinical presentation, management, and outcomes.
Purpose of the Study:
- To investigate the clinical and microbiological characteristics of PONF.
- To evaluate patient outcomes, including visual loss and mortality.
- To assess the role of antibiotic monotherapy in selected PONF cases.
Main Methods:
- Retrospective case series.
- Multi-center study across Australia and the UK (1990-2013).
- Analysis of clinical data, microbiology, treatment, and outcomes.
Main Results:
- 29 PONF patients identified; 55% had chronic immunocompromise.
- Group A Streptococcus was the most common pathogen (86%).
- 21% experienced systemic shock, 14% had visual loss, and one patient died.
Conclusions:
- PONF carries a better prognosis than NF in other body sites.
- Significant risks of visual loss and mortality persist.
- Intravenous antibiotics with cautious observation and debridement are key management strategies.
