Periorbital necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus periorbital necrotizing fasciitis.

Abstract

PURPOSE:

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: Canan Gürdal, Hakan Bilkan, Ozge Saraç, Ergin Seven, Mehmet Oğuz Yenidünya, Ahmet Kutluhan, Izzet Can
• Journal: Orbit (Amsterdam, Netherlands) (Orbit) Vol. 29 Issue 6 Pg. 348-50 (Dec 2010) ISSN: 1744-5108 [Electronic] England
• PMID: 20704488 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Adult
• Anti-Bacterial Agents (therapeutic use)
• Combined Modality Therapy
• Community-Acquired Infections (etiology, microbiology, therapy)
• Debridement (methods)
• Fasciitis, Necrotizing (microbiology, therapy)
• Follow-Up Studies
• Forehead (injuries)
• Humans
• Injury Severity Score
• Male
• Methicillin-Resistant Staphylococcus aureus
• Microbial Sensitivity Tests
• Orbit (injuries)
• Orbital Diseases (microbiology, physiopathology, therapy)
• Risk Assessment
• Staphylococcal Infections (diagnosis, etiology, therapy)
• Treatment Outcome
• Wounds, Nonpenetrating (complications)