Timoumi Rhyme, Moyal Laura, Nordmann Jean-Philippe, Bennedjai Amin
Centre Hospitalier National des Quinze Vingts, Sorbonne University, 28 rue de Charenton, 75012 Paris, France.
JPRAS Open. 2024 Sep 28;42:306-310. doi: 10.1016/j.jpra.2024.09.016. eCollection 2024 Dec.
Periorbital necrotising cellulitis is a rare localisation of fasciitis and an exceptional complication of cosmetic blepharoplasty. We discuss here the case of a 52-year-old woman who presented with orbital cellulitis 2 days after undergoing a bilateral cosmetic lower blepharoplasty. The diagnosis was confirmed on magnetic resonance imaging. Cellulitis was complicated by ocular hypertension resistant to local treatment and intravenous acetazolamide, leading to a decrease in visual acuity. Infection management consisted of intravenous antibiotics, corticosteroid bolus and drainage surgery. Bacteriological samples yielded resistant to all betalactamines. Anatomopathological analysis of the drained sample revealed an aspect compatible with necrotising cellulitis. To our knowledge, this is the seventh case of necrotising cellulitis occurring after blepharoplasty reported in the literature. The other cases were due to the virulent and required surgical debridement and antibiotics. Our case is unique, as it is the first reported case of necrotising cellulitis due to another pathogen, , which appears less virulent.
眶周坏死性蜂窝织炎是一种罕见的筋膜炎类型，也是美容性睑成形术的一种特殊并发症。我们在此讨论一名52岁女性的病例，该患者在接受双侧美容性下睑成形术2天后出现眼眶蜂窝织炎。磁共振成像确诊了该诊断。蜂窝织炎因对局部治疗和静脉注射乙酰唑胺耐药的眼压升高而复杂化，导致视力下降。感染管理包括静脉注射抗生素、大剂量皮质类固醇和引流手术。细菌学样本对所有β-内酰胺类药物耐药。引流样本的解剖病理学分析显示出与坏死性蜂窝织炎相符的表现。据我们所知，这是文献中报道的睑成形术后发生坏死性蜂窝织炎的第七例病例。其他病例是由毒性强的[病原体名称未给出]引起的，需要手术清创和使用抗生素。我们的病例是独特的，因为它是第一例报道的由另一种病原体[病原体名称未给出]引起的坏死性蜂窝织炎病例，这种病原体似乎毒性较小。
