title: Group A streptococcal necrotizing fasciitis of the eyelids and face managed with debridement and adjunctive intravenous immunoglobulin.
abstract: The authors describe a patient with right upper and lower eyelid necrosis combined with facial, neck, and chest edema and sepsis secondary to Group A streptococcal infection after minor trauma. This is an uncommon, life-threatening condition that was successfully treated with limited surgical debridement, antimicrobial therapy, and intravenous immunoglobulin. Oculoplastic surgeons should be aware of the indications and potential benefit of adjunctive intravenous immunoglobulin therapy for Group A Streptococcus-induced necrotizing fasciitis.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Immunology and International Medicine, Department of Medicine, University of Illinois at Chicago, College of Medicine, Chicago, IL 60612, USA. vaakalu@uic.edu
authors.forename: Vinay K
authors.initials: VK
authors.lastname: Aakalu
authors.forename: Kiran
authors.initials: K
authors.lastname: Sajja
authors.forename: James L
authors.initials: JL
authors.lastname: Cook
authors.forename: Amjad Z
authors.initials: AZ
authors.lastname: Ahmad
mesh_terms: D000328:Adult; D003646:Debridement / Q000379:methods*; D003937:Diagnosis, Differential; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D005141:Eyelid Diseases / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D005143:Eyelids / Q000382:microbiology; D005145:Face / Q000382:microbiology; D005148:Facial Dermatoses / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000008:administration & dosage; D008297:Male; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D013297:Streptococcus pyogenes / Q000302:isolation & purification
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors