Periocular necrotising fasciitis after traumatic laceration and concurrent COVID-19 infection:a case report  

Periocular necrotising fasciitis after traumatic laceration and concurrent COVID-19 infection:a case

作　　者：Terence Ang Thomas Rogerson Thilochana Nagolla Yugesh Caplash Dinesh Selva 

机构地区：[1]The University of Adelaide,Adelaide,South Australia,Australia [2]Department of Ophthalmology,The Royal Adelaide Hospital,Adelaide,South Australia,Australia [3]Department of Plastic and Reconstructive Surgery,Royal Adelaide Hospital,Adelaide,South Australia,Australia

出　　处：《Annals of Eye Science》2023年第1期3-7,共5页眼科学年鉴（英文）

摘　　要：Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechanisms of pathogenesis of COVID-19 infection and necrotising superinfections.Case Description:A 33-year-old previously healthy female presented with right-sided progressive periocular swelling,erythema,pain and fever,two days after sustaining a laceration to the right superolateral brow from a clenched fist.She had a concurrent COVID-19 infection,detected on nasopharyngeal polymerase chain reaction swab thirteen days prior to presentation and again at presentation.She did not have an oxygen requirement.There was a large bulbous collection of the right upper lid with fluctuance and overlying erythema,and a communicating sinus drained frank pus from the superolateral brow.Pre-operative T2-weighted MRI demonstrated fascial hyperintensity involving the pre-septal tissues and extending to the anterior temporal fossa.She was commenced on intravenous meropenem,clindamycin and vancomycin,and underwent early surgical debridement.Initial debridement demonstrated right upper lid necrosis involving the dermal and pre-septal layers,including the orbicularis,but sparing the tarsus.Streptococcus pyogenes was isolated,and she was continued on a prolonged course of intravenous antibiotic.Periocular defects were repaired with a right-sided brow adipo-fascial flap based on the supratrochlear artery,browpexy and dual full thickness skin grafts on the right upper lid and flap.Conclusions:NF is an acute fulminant infection rarely affecting the periocular tissues.This represents a unique case of periocular NF associated with a concurrent COVID-19 infection.

关 键 词：Necrotising fasciitis(NF) periocular COVID-19 INFECTION case report 

分 类 号：R77[医药卫生—眼科]