title: Periorbital necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus periorbital necrotizing fasciitis.
abstract: OBJECTIVE
  To report a case of a patient with periorbital necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus (MRSA).
  
  
  METHODS
  Case report. A previously healthy 33-year-old man was presented with pain and rapidly progressive swelling of the right upper eyelid following a minor trauma. Computed tomography scanning revealed soft tissue swelling and fracture of the anterior wall of the right frontal sinus. Oral amoxicillin + klavulanat 1 g, twice daily was started. Over the next 24 hours periorbital necrotizing fasciitis was developed. A wound swab was taken and sent for microscopic evaluation, culture, and antibiotic sensitivity. The patient was started on intravenous crystallized penicillin, third-generation cephalosporin, and metronidazol treatment. An urgent extensive necrotic tissue debridement and frontal sinus curettage were performed.
  
  
  RESULTS
  Wound culture yielded MRSA which showed sensitivity to the given antibiotics. The patient responded to the treatment which was continued for 14 days.
  
  
  CONCLUSIONS
  Monomicrobial MRSA should be considered in the etiology of periorbital necrotizing fasciitis. Early diagnosis and prompt surgical and medical therapy are essential in the management of periorbital necrotizing fasciitis.
authors: Atatürk Training and Research Hospital, 2nd Ophthalmology Department, Ankara, Turkey. gurdalcm@yahoo.com
authors: Canan
authors: C
authors: Gürdal
authors: Hakan
authors: H
authors: Bilkan
authors: Ozge
authors: O
authors: Saraç
authors: Ergin
authors: E
authors: Seven
authors: Mehmet Oğuz
authors: MO
authors: Yenidünya
authors: Ahmet
authors: A
authors: Kutluhan
authors: Izzet
authors: I
authors: Can
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017714:Community-Acquired Infections / Q000209:etiology / Q000382:microbiology / Q000628:therapy; D003646:Debridement / Q000379:methods; D019115:Fasciitis, Necrotizing / Q000382:microbiology* / Q000628:therapy; D005500:Follow-Up Studies; D005546:Forehead / Q000293:injuries; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008826:Microbial Sensitivity Tests; D009915:Orbit / Q000293:injuries*; D009916:Orbital Diseases / Q000382:microbiology* / Q000503:physiopathology / Q000628:therapy; D018570:Risk Assessment; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents