J Korean Ophthalmol Soc.  2020 Apr;61(4):418-422. 10.3341/jkos.2020.61.4.418.

Two Cases of Periorbital Necrotizing Fasciitis in Immunocompromised Patients

• Park SH
• Ahn JH

• KMID: 2500108
• DOI: http://doi.org/10.3341/jkos.2020.61.4.418

Abstract

Purpose
To report two cases of periorbital necrotizing fasciitis in immunocompromised patients.
Case Summary
(Case 1) A 55-year-old female with a history of diabetes and hepatic liver resection visited our clinic complaining of periorbital edema in her left eye 4 days prior to her visit. The visual acuity of the left eye was no light perception. Erythematous edema of the periorbital area and a black necrotic lesion in the left eye were observed. Periorbital necrotizing fasciitis was diagnosed and broad-spectrum antibiotics were injected. Urgent debridement was recommended but the patient went to another hospital and orbital exenteration was performed. K. pneumoniae was isolated in her blood culture. (Case 2) A 56-year-old female with a history of ovarian cancer chemotherapy visited our clinic complaining of periorbital pain and skin necrosis in her right eye 3 days prior to her visit. The visual acuity of the right eye could not be measured because of severe lid edema. Periorbital necrotizing fasciitis was diagnosed and antibiotic injection and urgent debridement were performed. P. aeruginosa was isolated in her blood culture. Postoperative infection progression and recurrence were not observed and eyelid reconstruction was performed.
Conclusions
Early detection and treatment of periorbital necrotizing fasciitis is important in immunocompromised patients. Proper antibiotic therapy and necrotic debridement are needed to remove the periorbital inflammation.

Keyword

Immunocompromised; Necrotizing fasciitis; Periorbital