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Periorbital necrotizing fasciitis: the Manchester experience
Abigail Hopkins1, Jonathan K Y Ng1, Jae Yee Ku2,3
1Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK.
BMC Ophthalmology
|April 17, 2025
Summary
Early antibiotics and surgical debridement prevented mortality in periorbital necrotizing fasciitis (PONF). Maintaining a high clinical suspicion and prompt specialist referral are crucial for managing this severe infection.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Surgical Pathology
Background:
- Periorbital necrotizing fasciitis (PONF) is a severe infection requiring prompt management.
- This study reviews the presentation and treatment of PONF patients.
Purpose of the Study:
- To describe the clinical presentation and management of PONF.
- To identify factors influencing outcomes in PONF patients.
Main Methods:
- Retrospective case series of 12 patients with PONF.
- Analysis of patient characteristics, risk factors, clinical findings, LRINEC scores, imaging, microbiology, histology, management, and mortality.
Main Results:
- Most patients were male, median age 63 years, with a median of 1 risk factor.
- Group A Streptococcus was common; all patients received antibiotics and surgical debridement.
- No mortality was observed, but 3 patients developed orbital compartment syndrome.
Conclusions:
- Early antibiotic treatment and surgical debridement are key to preventing mortality in PONF.
- A high index of clinical suspicion, utilizing the LRINEC score, is vital, especially in high-risk individuals.
- Urgent referral to specialist surgical teams is essential for optimal outcomes.
