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  • Title: Periocular necrotizing fasciitis causing blindness.
    Author: Shield DR, Servat J, Paul S, Turbin RE, Moreau A, de la Garza A, El Rassi E, Silbert J, Lesser R, Levin F.
    Journal: JAMA Ophthalmol; 2013 Sep; 131(9):1225-7. PubMed ID: 23868053.
    Abstract:
    IMPORTANCE: Periocular necrotizing fasciitis is a rare but potentially devastating disease, accompanied by high rates of morbidity and mortality. OBSERVATIONS: 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 AND RELEVANCE: 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.
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