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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 71-72

Facial necrotizing fasciitis with periorbital involvement


Department of General Surgery, Hemwati Nandan Bahuguna Base Hospital, Veer Chandra Singh Garhwali, Government Institute of Medical Sciences & Research, Srinagar 246 174, Uttarakhand, India

Date of Submission13-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Keshri Amit
Department of General Surgery, Hemwati Nandan Bahuguna Base Hospital, Veer Chandra Singh Garhwali, Government Institute of Medical Sciences & Research, Srinagar 246 174, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_2070_19

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How to cite this article:
Negi A, Amit K. Facial necrotizing fasciitis with periorbital involvement. Indian J Med Res 2020;152, Suppl S1:71-2

How to cite this URL:
Negi A, Amit K. Facial necrotizing fasciitis with periorbital involvement. Indian J Med Res [serial online] 2020 [cited 2021 Aug 4];152, Suppl S1:71-2. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/71/316700

Patient's consent obtained to publish clinical information and images.


A 32 yr old male presented to the emergency medical service at the HNB Base Hospital, VCSGGIMSR, Srinagar, Garhwal, India, in August 2018, with trauma to the left side of face causing skin ulceration. The ulcer was debrided, irrigated and sutured. After three days, he returned to the surgery outpatient department, complaining of swelling, erythema, purulent discharge, fever and blackish necrotic skin [Figure 1]. A reduction in the left visual acuity was noted. Blood results identified a marked neutrophilia (10,000 cells/μl) and raised C-reactive protein level (60 mg/l). Further, debridements [Figure 2] and intermediate-thickness skin grafting [Figure 3] were done, along with intravenous penicillin G and clindamycin. Laboratory culture of blood and tissue samples showed a florid growth of Group A beta-haemolytic streptococci, confirming the clinical suspicion of necrotizing fasciitis. At four months of follow up, the patient recovered gradually.
Figure 1: Patient having blackish necrotic skin (arrow) on the face involving periorbital area (facial necrotizing fasciitis).

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Figure 2: Wound after aggressive acute debridement (arrow) of necrotizing fasciitis.

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Figure 3: Face of the patient after skin grafting (arrow).

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Necrotizing fasciitis, although common in lower extremity, is rare on the face due to rich vascularity.

Conflicts of Interest: None.


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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