Enterococcus necrotising fasciitis of the face after minor trauma presenting as periorbital cellulitis

Necrotising fasciitis (NF), commonly referred to as 'flesh-eating disease', is a rare but life-threatening infection. It rapidly affects subcutaneous tissue, leading to necrosis of the overlying skin. Though primarily seen in the abdomen, perineum and lower limbs, periorbital involvement is rare. This case report presents an elderly male with periorbital NF following a minor head injury. The patient presented with bilateral periorbital swelling, purulent discharge and necrotic tissue. Microbiological analysis revealed a rare Enterococcus species as the causative pathogen. MRI and microbiological analysis confirmed the diagnosis. Treatment included intravenous antibiotics, surgical debridement and skin grafting. The patient showed significant improvement post-treatment. This case underscores the importance of prompt diagnosis and treatment to prevent severe complications.