Eyelid necrotizing fasciitis

Background Necrotizing fasciitis is a rare, destructive life-threatening subcutaneous soft tissue infection that rarely affects the eyelids. Many types of bacteria can cause necrotizing fasciitis. Group A Streptococcus was detected in most cases.

Objective To take a look at the symptoms, differential diagnoses, and the warning sign of this disease through the presentation of a rare case of necrotizing fasciitis in the lid area.

Case report A 67-year-old patient was referred to our clinic as a referral from an eye clinic with a preseptal eyelid infection and massive swelling and skin necrosis on the right side. The magnetic resonance tomography showed a pronounced eyelid phlegmon with abscess formation, which developed more on the upper eyelid than on the lower eyelid. Emergency surgical debridement and intravenous administration of piperacillin/tazobactam 4 G / 0.5 (3 times daily) and clindamycin 600 mg 3 times daily were indicated. The microbiological and histological results rule out mucormycosis and confirm the necrotizing fasciitis with Streptococcus of group A. The postoperative course resulted in a clear improvement of the local findings. When checked by an ophthalmologist, there was no visual impairment.

Conclusion Despite the severe course of this disease and the life-threatening sequelae, rapid diagnosis and extensive surgical debridement can reduce the consequential damage and ensure visual function. Mucormycosis should be excluded as a differential diagnosis

Publication History

Article published online:
24 May 2022