title: Periocular necrotizing fasciitis causing blindness.
abstract: OBJECTIVE
  Periocular necrotizing fasciitis is a rare but potentially devastating disease, accompanied by high rates of morbidity and mortality.
  
  
  METHODS
  We report 5 cases of periocular necrotizing fasciitis resulting in severe vision loss, 3 of which required exenteration to contain the disease and only 1 of which recovered vision. Three cases were caused by group A streptococcus; 1, by methicillin-resistant Staphylococcus aureus; and 1, by Streptococcus anginosus constellatus.
  
  
  CONCLUSIONS
  Providers should maintain a high clinical suspicion for necrotizing fasciitis and distinguish it from more common forms of cellulitis. As seen in these 5 cases, periocular necrotizing fasciitis may cause severe visual loss more often than previously recognized. To our knowledge, this is also the first report of Streptococcus anginosus constellatus causing necrotizing fasciitis.
authors.affiliation: Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: David R
authors.initials: DR
authors.lastname: Shield
authors.forename: Javier
authors.initials: J
authors.lastname: Servat
authors.forename: Sean
authors.initials: S
authors.lastname: Paul
authors.forename: Roger E
authors.initials: RE
authors.lastname: Turbin
authors.forename: Annie
authors.initials: A
authors.lastname: Moreau
authors.forename: Adam
authors.initials: A
authors.lastname: de la Garza
authors.forename: Edward
authors.initials: E
authors.lastname: El Rassi
authors.forename: Jonathan
authors.initials: J
authors.lastname: Silbert
authors.forename: Robert
authors.initials: R
authors.lastname: Lesser
authors.forename: Flora
authors.initials: F
authors.lastname: Levin
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001766:Blindness / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D003131:Combined Modality Therapy; D003646:Debridement; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005141:Eyelid Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D009916:Orbital Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents