Orbit (Amsterdam, Netherlands) · 2010
Periorbital necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus periorbital necrotizing fasciitis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Gürdal Canan, Bilkan Hakan, Saraç Ozge, Seven Ergin, Yenidünya Mehmet Oğuz, Kutluhan Ahmet, Can Izzet
Аннотация
PURPOSE: To report a case of a patient with periorbital necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus (MRSA).
METHODS: Case report. A previously healthy 33-year-old man was presented with pain and rapidly progressive swelling of the right upper eyelid following a minor trauma. Computed tomography scanning revealed soft tissue swelling and fracture of the anterior wall of the right frontal sinus. Oral amoxicillin + klavulanat 1 g, twice daily was started. Over the next 24 hours periorbital necrotizing fasciitis was developed. A wound swab was taken and sent for microscopic evaluation, culture, and antibiotic sensitivity. The patient was started on intravenous crystallized penicillin, third-generation cephalosporin, and metronidazol treatment. An urgent extensive necrotic tissue debridement and frontal sinus curettage were performed.
RESULTS: Wound culture yielded MRSA which showed sensitivity to the given antibiotics. The patient responded to the treatment which was continued for 14 days.
CONCLUSIONS: Monomicrobial MRSA should be considered in the etiology of periorbital necrotizing fasciitis. Early diagnosis and prompt surgical and medical therapy are essential in the management of periorbital necrotizing fasciitis.
METHODS: Case report. A previously healthy 33-year-old man was presented with pain and rapidly progressive swelling of the right upper eyelid following a minor trauma. Computed tomography scanning revealed soft tissue swelling and fracture of the anterior wall of the right frontal sinus. Oral amoxicillin + klavulanat 1 g, twice daily was started. Over the next 24 hours periorbital necrotizing fasciitis was developed. A wound swab was taken and sent for microscopic evaluation, culture, and antibiotic sensitivity. The patient was started on intravenous crystallized penicillin, third-generation cephalosporin, and metronidazol treatment. An urgent extensive necrotic tissue debridement and frontal sinus curettage were performed.
RESULTS: Wound culture yielded MRSA which showed sensitivity to the given antibiotics. The patient responded to the treatment which was continued for 14 days.
CONCLUSIONS: Monomicrobial MRSA should be considered in the etiology of periorbital necrotizing fasciitis. Early diagnosis and prompt surgical and medical therapy are essential in the management of periorbital necrotizing fasciitis.
Предметные рубрики MeSH
AdultAnti-Bacterial AgentsCombined Modality TherapyCommunity-Acquired InfectionsDebridementFasciitis, NecrotizingFollow-Up StudiesForeheadHumansInjury Severity ScoreMaleMethicillin-Resistant Staphylococcus aureusMicrobial Sensitivity TestsOrbitOrbital DiseasesRisk AssessmentStaphylococcal InfectionsTreatment OutcomeWounds, Nonpenetrating