• Aisling McGlacken-Byrne and Gareth T Higgins.
• Department of Ophthalmology, University Hospital Waterford, Dunmore Rd, Ballynakill, Waterford, X91 ER8E, Ireland. aislingmcgb@gmail.com.
• Ir J Med Sci. 2024 Oct 10.

BackgroundNecrotising fasciitis is a devastating infection characterised by rapidly progressing necrotising infection of the superficial fascia with secondary necrosis of the overlying skin.AimsTo describe the pathophysiology, differential diagnosis, and outcome in a rare case of periorbital necrotising fasciitis caused by group A β-haemolytic Streptococcus.MethodsA 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.ResultsA combination of intravenous antibiotics and surgical debridement and subsequent skin grafting resulted in a beneficial outcome in our patient.ConclusionsDifferentiating 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.© 2024. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

4 keywords...

hide…