Streptococcal necrotizing fasciitis complicating a conjunctival dacryocystorhinostomy.
Necrotizing fasciitis is a rare infection of the deep and subcutaneous tissue layers most commonly caused by group A beta-hemolytic Streptococcus. The disease begins as a typical cellulitis. Necrosis of the deeper tissues progresses rapidly, accompanied by a dusky, gray-blue skin discoloration with erythematous margins. Even with appropriate treatment, mortality rates remain as high as 36%. Most cases of necrotizing fasciitis have been reported in the general surgical literature, associated with trauma or as a postoperative wound infection after abdominal and gynecologic procedures. Of the 50 cases involving the eyelids reported in the literature, only three were reported to have occurred as a "postoperative" complication. This report is of the first known case of streptococcal necrotizing fasciitis complicating a conjunctival dacryocystorhinostomy.
Krieger Eye Institute, Sinai Hospital of Baltimore, MD 21215, USA.
M J
MJ
Hirschbein
S E
SE
LaBorwit
J W
JW
Karesh
D000368:Aged; D000900:Anti-Bacterial Agents; D003228:Conjunctiva / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D003608:Dacryocystorhinostomy / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D013291:Streptococcus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents