Park Jinhwan, Kim Seungheon, Lee Byungil, Baek Sehyun
Department of Ophthalmology.
Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea.
J Craniofac Surg. 2019 May/Jun;30(3):e245-e247. doi: 10.1097/SCS.0000000000005199.
Periorbital necrotizing fasciitis (NF) is a very rare disease with a mortality rate of 10% to 20%, requiring rapid diagnosis and active treatment. The most common causative organism is Group A β-hemolytic Streptococcus, and trauma, operative incisions, pre-existing ulcers, or injection sites may be predisposing factors for periorbital NF. In this study, the subject, who had a medical history of diabetes mellitus and chronic liver disease, developed periorbital NF suddenly and without any specific triggering factors, and Klebsiella pneumoniae was identified in a necrotic tissue biopsy. Klebsiella pneumoniae has not been reported as a causative organism of periorbital NF. It is believed that latent infection with K pneumoniae, which caused a brain abscess in the patient 2 years prior, caused inflammation around the periorbit by hematogenous spread. The authors were able to manage the patient successfully by performing total exenteration and reconstructing the affected site using a transverse rectus abdominis myocutaneous flap procedure.
眶周坏死性筋膜炎（NF）是一种非常罕见的疾病，死亡率为10%至20%，需要快速诊断和积极治疗。最常见的病原体是A组β溶血性链球菌，创伤、手术切口、既往溃疡或注射部位可能是眶周NF的诱发因素。在本研究中，该患者有糖尿病和慢性肝病病史，无任何特定触发因素突然发生眶周NF，坏死组织活检中发现肺炎克雷伯菌。肺炎克雷伯菌尚未被报道为眶周NF的病原体。据信，该患者两年前因肺炎克雷伯菌潜伏感染导致脑脓肿，通过血行播散引起眶周炎症。作者通过进行全眶内容剜除术并使用腹直肌横形肌皮瓣手术重建受影响部位，成功治疗了该患者。
