Fungal periorbital necrotizing fasciitis in an immunocompetent adult.
A 55-year-old man presented with profound swelling of the upper face and fever with a history of preceding insect bite. He was nonalcoholic and immunocompetent. Orbital CT showed a predominantly preseptal soft-tissue swelling. Empiric treatment with broad-spectrum antibiotics resulted in partial response. Surgical debridement and microbiologic evaluation of the necrotic tissue were performed. Gram stain showed budding yeast cells. Candida and Aspergillus spp. grew in culture after 48 hours. The patient received oral fluconazole, 200 mg once a day for 8 weeks. Complete resolution was documented at 16 weeks. In tropical regions, Candida and Aspergillus spp. may cause periorbital necrotizing fasciitis in immunocompetent adults.
Rath
Suryasnata
S
Ophthalmic Plastic Surgery, Orbit and Ocular Oncology Service, L.V. Prasad Eye Institute, Bhubaneswar, Orissa, India. suryasnata@lvpei.org
Kar
Sarita
S
Sahu
Srikant K
SK
Sharma
Savitri
S
D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D003937:Diagnosis, Differential; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015725:Fluconazole / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D015725:Fluconazole