McGlacken-Byrne Aisling, Higgins Gareth T
Department of Ophthalmology, University Hospital Waterford, Dunmore Rd, Ballynakill, Waterford, X91 ER8E, Ireland.
Ir J Med Sci. 2025 Feb;194(1):189-193. doi: 10.1007/s11845-024-03820-4. Epub 2024 Oct 10.
Necrotising fasciitis is a devastating infection characterised by rapidly progressing necrotising infection of the superficial fascia with secondary necrosis of the overlying skin.
To describe the pathophysiology, differential diagnosis, and outcome in a rare case of periorbital necrotising fasciitis caused by group A β-haemolytic Streptococcus.
A 60-year-old female with insulin-dependent diabetes presented with pyrexia and bilateral peri-orbital swelling, progressing to left periorbital necrotising fasciitis. It was caused by dual infection with group A β-haemolytic Streptococcus and Herpes Simplex Virus 1.
A combination of intravenous antibiotics and surgical debridement and subsequent skin grafting resulted in a beneficial outcome in our patient.
Differentiating cellulitis and necrotising fasciitis can be difficult when presenting signs and symptoms are non-specific. If not treated quickly with antibiotics and debridement of the infected tissue, the patient may develop septic shock within hours.
坏死性筋膜炎是一种严重的感染性疾病，其特征为浅筋膜迅速进展的坏死性感染并伴有上层皮肤的继发性坏死。
描述由A组β溶血性链球菌引起的罕见眶周坏死性筋膜炎病例的病理生理学、鉴别诊断及转归。
一名60岁的胰岛素依赖型糖尿病女性患者，出现发热及双侧眶周肿胀，进而发展为左侧眶周坏死性筋膜炎。该疾病由A组β溶血性链球菌和单纯疱疹病毒1双重感染所致。
静脉使用抗生素、手术清创及随后的皮肤移植相结合，使我们的患者获得了良好的治疗效果。
当临床表现和症状不具有特异性时，区分蜂窝织炎和坏死性筋膜炎可能会很困难。如果不迅速使用抗生素及对感染组织进行清创治疗，患者可能在数小时内发生感染性休克。
