Jain Jagriti, Thatte Shreya, Singhai Prakhar
Department of Ophthalmology, Sri Aurobindo Institute of Medical Science and P.G. Institute, Indore, Madhya Pradesh, India.
Oman J Ophthalmol. 2015 Jan-Apr;8(1):64-6. doi: 10.4103/0974-620X.149874.
A previously healthy six year old male child presented in pediatrics ICU in state of shock with history of fever and rashes and later was diagnosed as chicken pox. He developed right sided periorbital varicella gangrenosa which is a form of necrotizing fasciitis secondary to skin infection. Patient was treated with intravenous acyclovir, antibiotics, amphotericin B, extensive debridement and later reconstruction of upper eyelid with skin grafting. Aggressive treatment helped preventing the eyeball and orbital involvement which would have necessitated orbital exenteration. However delayed presentation resulted in necrosis of orbicularis oculi and underlying tissue which resulted in graft retraction and lid dysfunction. Clinicians should be aware of this rare but fulminating condition to minimise the sight and life threatening complications associated with it.
一名此前健康的6岁男童因发热和皮疹病史,以休克状态被送入儿科重症监护病房,后来被诊断为水痘。他患上了右侧眶周坏疽性水痘,这是一种继发于皮肤感染的坏死性筋膜炎。患者接受了静脉注射阿昔洛韦、抗生素、两性霉素B治疗,进行了广泛的清创,后来通过植皮对上眼睑进行了重建。积极的治疗有助于防止眼球和眼眶受累,否则将需要进行眶内容摘除术。然而,就诊延迟导致眼轮匝肌和深层组织坏死,从而导致移植皮片回缩和眼睑功能障碍。临床医生应意识到这种罕见但暴发性的疾病,以尽量减少与之相关的视力和危及生命的并发症。