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双侧眶周坏死性筋膜炎:病例报告

Bilateral periorbital necrotizing fasciitis: case report.

作者信息

Leonardo Fabio Henrique Luiz, Anabuki Mariana, Gonçalves Allan Christian Pieroni

机构信息

Department of Ophthalmology, Faculdade de Medicina do ABC, Santo André, SP, Brazil.

BWS Institute de Dermatologia de São Paulo, São Paulo, SP, Brazil.

出版信息

Arq Bras Oftalmol. 2018 Jun;81(3):239-241. doi: 10.5935/0004-2749.20180047.

Abstract

Necrotizing fasciitis is a severe infection of the subcutaneous tissue characterized by necrosis of the superficial fascia and overlying skin and is usually associated with previous trauma and comorbidities. Periorbital necrotizing fasciitis is rare and commonly causes visual loss and soft tissue defects. A better prognosis relies critically on early diagnosis, prompt medical treatment, and timely surgical intervention. We describe a rare case of periorbital necrotizing fasciitis in the absence of an inciting event. A 55-year-old female patient presented with acute painful swelling and redness of the right upper eyelid that spread to both eyelids bilaterally within 24 h. We swiftly started the patient on intravenous antibiotic therapy, and we surgically debrided the necrotic tissue the following day. We performed two further procedures to improve eyelid closure and appearance. Despite the severe presentation, timely antibiotic therapy and proper surgical interventions led to a successful outcome in this case.

摘要

坏死性筋膜炎是一种皮下组织的严重感染,其特征为浅筋膜及覆盖其上的皮肤坏死,通常与既往创伤和合并症有关。眶周坏死性筋膜炎罕见,常导致视力丧失和软组织缺损。更好的预后关键取决于早期诊断、及时的药物治疗和适时的手术干预。我们描述了一例无诱发事件的罕见眶周坏死性筋膜炎病例。一名55岁女性患者出现右上眼睑急性疼痛性肿胀和发红,24小时内双侧眼睑均受累。我们迅速开始对患者进行静脉抗生素治疗,并于次日手术清除坏死组织。我们又进行了两次手术以改善眼睑闭合和外观。尽管病情严重,但及时的抗生素治疗和恰当的手术干预使该病例取得了成功的结果。

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