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A case of periorbital necrotizing fasciitis rapidly progressing to severe multiorgan failure

Paola Eiben1, Sancho Rodriguez-Villar1

  • 1Department of Critical Care Medicine, King's College Hospital NHS Foundation Trust, SE5 9RS London, UK.

Journal of Surgical Case Reports
|May 17, 2018
PubMed

Insights

Periorbital necrotizing fasciitis (PNF) can be a devastating infection, even if typically milder than in other body areas. This case shows PNF can rapidly cause severe systemic illness and organ failure, requiring urgent intervention.

Area of Science:

  • Infectious Diseases
  • Ophthalmology
  • Critical Care Medicine

Background:

  • Periorbital necrotizing fasciitis (PNF) is a rare, severe subcutaneous infection affecting the periorbital region.
  • While generally less severe than necrotizing fasciitis elsewhere, PNF poses risks of disfigurement, blindness, and death.

Observation:

  • A 60-year-old male presented with PNF that rapidly progressed to systemic involvement.
  • The patient developed severe multiorgan failure, necessitating ventilatory, cardiovascular, and renal support.

Findings:

  • Prompt treatment with broad-spectrum antibiotics, intravenous immunoglobulin, and surgical debridement was initiated.
  • The case demonstrated the potential for rapid deterioration and life-threatening complications from PNF.

Implications:

  • Early recognition and aggressive management, including urgent surgical intervention, are critical for improving outcomes in PNF.
  • This case underscores the severe systemic risks associated with PNF, challenging the perception of its typically milder course.

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