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Facial necrotizing fasciitis with periorbital involvement
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
A 32 yr old male† presented to the emergency medical service at the HNB Base Hospital, VCSGGIMSR, Srinagar, Garhwal, India, in August 2018, with trauma to the left side of face causing skin ulceration. The ulcer was debrided, irrigated and sutured. After three days, he returned to the surgery outpatient department, complaining of swelling, erythema, purulent discharge, fever and blackish necrotic skin (Fig. 1). A reduction in the left visual acuity was noted. Blood results identified a marked neutrophilia (10,000 cells/μl) and raised C-reactive protein level (60 mg/l). Further, debridements (Fig. 2) and intermediate-thickness skin grafting (Fig. 3) were done, along with intravenous penicillin G and clindamycin. Laboratory culture of blood and tissue samples showed a florid growth of Group A beta-haemolytic streptococci, confirming the clinical suspicion of necrotizing fasciitis. At four months of follow up, the patient recovered gradually.
- Patient having blackish necrotic skin (arrow) on the face involving periorbital area (facial necrotizing fasciitis).
- Wound after aggressive acute debridement (arrow) of necrotizing fasciitis.
- Face of the patient after skin grafting (arrow).
Necrotizing fasciitis, although common in lower extremity, is rare on the face due to rich vascularity.
Conflicts of Interest: None.
