Group a streptococcus necrotizing fasciitis of the eyelid: a case report of good outcome with medical management.

Periorbital necrotizing fasciitis is a potentially fatal disease, and early surgical debridement has been advocated to minimize the risk of blindness and mortality. The authors report a case of an 18-year-old man who presented with isolated, unilateral group A Streptococcus eyelid necrotizing fasciitis. The patient responded to intravenous antibiotics alone, and no surgical debridement was needed. Skin reconstructive surgery was carried out after resolution of the acute infection. The clinical and cosmetic outcome was good. This case report supports limited but growing evidence that potentially disfiguring surgical debridement may be avoided in selected cases of eyelid necrotizing fasciitis and that uncomplicated periorbital necrotizing fasciitis can be treated conservatively with good results.