Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut.
JAMA Ophthalmol. 2013 Sep;131(9):1225-7. doi: 10.1001/jamaophthalmol.2013.4816.
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.
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.
眼周坏死性筋膜炎是一种罕见但具有潜在破坏性的疾病，其发病率和死亡率均很高。
我们报告了 5 例眼周坏死性筋膜炎导致严重视力丧失的病例，其中 3 例需要进行眼眶内容剜除以控制疾病，只有 1 例恢复了视力。3 例由 A 组链球菌引起；1 例由耐甲氧西林金黄色葡萄球菌引起；1 例由星座链球菌引起。
医务人员应保持对坏死性筋膜炎的高度临床警惕，并将其与更常见的蜂窝织炎区分开来。正如这 5 例病例所示，眼周坏死性筋膜炎可能比以前认识到的更常导致严重的视力丧失。据我们所知，这也是星座链球菌引起坏死性筋膜炎的首例报告。
