Facial necrotizing fasciitis following acute dacryocystitis.

PURPOSE: To report a case of progressive necrotizing fasciitis of the face following acute dacryocystitis.

DESIGN

Interventional case report.

METHODS

A 60-year-old woman presented with left acute dacryocystitis with abscess formation that had ruptured; a small wound remained. Erythematous swelling of the left eyelid and face developed 3 days later. Clinical progression and computed tomographic findings led to the diagnosis of necrotizing fasciitis with abscess formation. Early intravenous antibiotics and repeated surgical debridements were performed.

RESULTS

Soft tissue necrosis was found the fascial planes extending deep to the maxilla bone and periorbital fat. The patient was successfully treated without ocular, orbital, or facial complications.

CONCLUSIONS

Necrotizing fasciitis of the eyelid and face progresses rapidly. Early diagnosis, prompt intravenous antibiotic administration, and aggressive surgical debridement will prevent the associated morbidity and mortality.