Periorbital Necrotizing Fasciitis caused by Posttraumatic Facial Angioedema

Abstract

Necrotizing fasciitis is a rare, rapidly progressive soft tissue infection that is highly destructive and causes necrosis of the skin, subcutaneous tissue and fascia. It is a rare and potentially fatal disease; periocular forms of the disease are even rarer and can have serious consequences for the patient. We present a 36-year-old female patient with type 2 diabetes mellitus, who after a clinical picture of angioneurotic edema presented with necrotizing fasciitis of the upper and lower eyelids of the left eye. The objective was to describe the clinical evolution of the patient. The main symptoms and signs presented at admission and hospital stay are described. Complementary examinations, general measures and topical and systemic broad-spectrum antibiotics were indicated. The necrotic tissue of the upper and lower eyelid of the left eye was excised and the spaces were left with gauze with nitrofurazone and tetracycline antibiotics. Cures were performed with iodine and the slough was removed until granulation tissue and definitive healing appeared. After two months of treatment and compensation of her underlying disease, the patient was discharged satisfactorily.