Periorbital Necrotizing Fasciitis: Presentation to management

Area of Science:

• Ophthalmology
• Plastic Surgery
• Infectious Diseases

Background:

• Periorbital necrotizing fasciitis is a rare, rapidly progressing infection with high morbidity and mortality.
• Early symptoms are nonspecific, delaying diagnosis and treatment.
• Standard management (aggressive debridement) is challenging in the periorbital region due to risks to vision and cosmesis.

Observation:

• An 85-year-old male presented with a suspected upper eyelid abscess and rapid clinical deterioration.
• The patient underwent two surgical debridements of the periorbital area.
• Reconstruction utilized a Mustardé cheek advancement flap and a full-thickness skin graft.

Findings:

• The patient experienced no surgical complications.
• Aesthetic and functional improvements were noted shortly after reconstruction.
• Successful reconstruction highlights the viability of advanced surgical techniques in complex cases.

Implications:

• Early recognition and debridement are critical for favorable outcomes in periorbital necrotizing fasciitis.
• Reconstructive surgery techniques, such as those employed, can achieve satisfactory cosmetic and functional results.
• This case underscores the importance of tailored surgical approaches for periorbital infections.