title: [Necrotising soft tissue infection of orbital area and hand: an unusual combination].
abstract: Necrotising soft tissue infection (NSTI) is an infection of the subcutaneous tissues and often follows a fulminant course if not recognised in time.
  
  
  
  A 78-year-old man was brought to our emergency department in septic shock. Physical examination revealed an erythematous and painful swelling of the right eyelids and to a lesser extent of the right hand. The infection progressed at both sites, and suspicion of NSTI arose. An emergency surgical debridement was performed. Pathological examination of the excised tissue confirmed the presence of a necrotising infection of the fascia consistent with NSTI at both sites.
  
  
  
  This case history describes a, not previously described, 'double' presentation of NSTI. In a patient with misunderstood sepsis in combination with a soft tissue infection, it is important to consult a surgeon immediately. This case report emphasises the need for a multidisciplinary approach when treating patients with these clinical pictures.
  
  
  
  NONE DECLARED.
authors.affiliation: Groene Hart Ziekenhuis, Gouda.
authors.forename: M P M
authors.initials: MP
authors.lastname: Paridaans
authors.forename: J A
authors.initials: JA
authors.lastname: Govaert
authors.forename: E H
authors.initials: EH
authors.lastname: Scholten
authors.forename: D H
authors.initials: DH
authors.lastname: de Lange
mesh_terms: D000368:Aged; D001762:Blepharitis / Q000150:complications* / Q000601:surgery; D003646:Debridement; D006225:Hand / Q000382:microbiology; D006801:Humans; D008297:Male; D009140:Musculoskeletal Diseases / Q000150:complications* / Q000601:surgery; D012772:Shock, Septic / Q000382:microbiology*; D018461:Soft Tissue Infections / Q000150:complications* / Q000601:surgery