title: Necrotizing fasciitis of the eyelids.
abstract: Necrotizing fasciitis is a destructive soft tissue infection that rarely involves the eyelids. Three cases of necrotizing fasciitis of the eyelids are described. Necrotizing fasciitis was preceded by minor forehead soft tissue trauma in two cases and occurred spontaneously in one. In two patients necrotizing fasciitis was bilateral and involved both the upper and lower eyelids. Review of these cases, in addition to 18 cases previously reported in the English literature, reveals a predominance in females, preceding minor local soft tissue trauma, frequent bilateral involvement, and an association with alcohol abuse and diabetes. In all of the patients, group A beta-hemolytic streptococci were cultured from the wound. Early recognition of the disease process, prompt surgical debridement of the necrotic tissue, aggressive antimicrobial therapy, and delayed skin grafting combine to minimize morbidity.
authors.affiliation: Department of Otolaryngology--Head and Neck Surgery, University of Washington, Seattle 98195.
authors.forename: E M
authors.initials: EM
authors.lastname: Overholt
authors.forename: P W
authors.initials: PW
authors.lastname: Flint
authors.forename: E L
authors.initials: EL
authors.lastname: Overholt
authors.forename: C S
authors.initials: CS
authors.lastname: Murakami
mesh_terms: D000437:Alcoholism / Q000150:complications; D001762:Blepharitis / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D003646:Debridement; D005208:Fasciitis / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D013290:Streptococcal Infections; D013297:Streptococcus pyogenes