Periocular necrotizing fasciitis is a rare but potentially devastating disease, accompanied by high rates of morbidity and mortality.
We report 5 cases of periocular necrotizing fasciitis resulting in severe vision loss, 3 of which required exenteration to contain the disease and only 1 of which recovered vision. Three cases were caused by group A streptococcus; 1, by methicillin-resistant Staphylococcus aureus; and 1, by Streptococcus anginosus constellatus.
Conclusions and Relevance
Providers should maintain a high clinical suspicion for necrotizing fasciitis and distinguish it from more common forms of cellulitis. As seen in these 5 cases, periocular necrotizing fasciitis may cause severe visual loss more often than previously recognized. To our knowledge, this is also the first report of Streptococcus anginosus constellatus causing necrotizing fasciitis.
Shield DR, Servat J, Paul S, Turbin RE, Moreau A, de la Garza A, El Rassi E, Silbert J, Lesser R, Levin F. Periocular Necrotizing Fasciitis Causing Blindness. JAMA Ophthalmol. 2013;131(9):1225-1227. doi:10.1001/jamaophthalmol.2013.4816