Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Knipe H, Periorbital necrotizing fasciitis. Reference article, Radiopaedia.org (Accessed on 12 May 2024) https://doi.org/10.53347/rID-178291
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Integral Diagnostics, Shareholder (ongoing)
- Micro-X Ltd, Shareholder (ongoing)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Henry Knipe's current disclosures
Periorbital necrotizing fasciitis is an uncommon but serious condition caused by rapidly spreading periorbital infection with the potential for progressive vascular thrombosis and subcutaneous necrosis.
The initial appearance may look like periorbital cellulitis although necrosis can quickly follow 4.
The most common precipitating event is considered minor penetrating or surgical trauma but in ~25% of cases no trigger can be identified. It can be bilateral in ~ 35% of cases 1.
It usually occurs from infection from beta-hemolytic Streptococcus pyogenes / group A streptococcus. Rarely other organisms such as Pseudomonas aeruginosa 6 and herpes zoster7 have been reported.
CT
Treatment and prognosis
Although periorbital necrotizing fasciitis is thought to carry a better prognosis than necrotizing fasciitis at other sites, (mortality rate 8.5% compared with 22%), it can still carry considerable morbidity:
Early surgical intervention can reduce morbidity and mortality.
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1. McCabe G, Hardy T, Campbell T. Bilateral Periorbital Necrotising Fasciitis Associated with Invasive Group: A Infection. BMJ Case Rep. 2020;13(12):e236800. doi:10.1136/bcr-2020-236800 - Pubmed
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2. Rose G, Howard D, Watts M. Periorbital Necrotising Fasciitis. Eye. 1991;5(6):736-40. doi:10.1038/eye.1991.135 - Pubmed
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3. Tambe K, Tripathi A, Burns J, Sampath R. Multidisciplinary Management of Periocular Necrotising Fasciitis: A Series of 11 Patients. Eye (Lond). 2012;26(3):463-7. doi:10.1038/eye.2011.241 - Pubmed
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4. Poitelea C & Wearne M. Periocular Necrotising Fasciitis--A Case Report. Orbit. 2005;24(3):215-7. doi:10.1080/01676830590930634 - Pubmed
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5. Khurana S, Pushker N, Naik S, Changole M, Ghonsikar V, Bajaj M. Periorbital Necrotising Fasciitis in Infants: Presentation and Management of Six Cases. Trop Doct. 2015;45(3):188-93. doi:10.1177/0049475515575671 - Pubmed
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6. Lim V & Amrith S. Necrotising Fasciitis of the Eyelid with Toxic Shock Due to Pseudomonas Aeruginosa. Singapore Med J. 2010;51(3):e51-3. - Pubmed
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7. Fung V, Rajapakse Y, Longhi P. Periorbital Necrotising Fasciitis Following Cutaneous Herpes Zoster. J Plast Reconstr Aesthet Surg. 2012;65(1):106-9. doi:10.1016/j.bjps.2011.06.034 - Pubmed
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