Abstract
Purpose: Two cases of eyelids Necrotizing Fasciitis in children were presented. The first one with chicken pox, and the second was previously healthy.Design: Interventional Report cases. Methods: Two cases of eyelids Necrotizing Fasciitis in children were studied. The first case was a 7 years old girl who presented a necrotizing fasciitis in superior and inferior eyelids with a serious toxic shock as a complication of the chicken pox. Parenteral antibiotic treatment was not enough to stop the necrotizing process and surgical debriding was needed for the gangrenous tissues. In the eyelid culture Streptococcus pyogenes grew. A free skin graft was implanted to the inferior eyelid. The second case was presented in a 6 months old girl, who developed necrotizing fasciitis of her lower left eyelid without any trauma antecedent. The ocular and blood cultures did not show any microorganism growth. An appropriate antibiotic coverage and management of systemic manifestations leads to a fast recovering; even though the developed necrosis demanded surgical debriding and a retroauricular free skin graft was performed later.
Highlights
The Necrotizing Fasciitis (NF) is a severe and uncommon bacterial infection that involves all the subcutaneous tissue, specially the fascia, fat tissue, muscles and necrotizes the overlying skin [1,2] occurring most commonly in the lower extremities, trunk, and it rarely involves the neck and head [3,4]
The facial involvement is very infrequent due to the excellent blood supply in the area. These infections are caused by a wide variety of organisms, which includes Gram -positive and Gram negative bacteria, either aerobic or anaerobic [2]
A 6 months old girl is accepted at the pediatric emergency room with a report on a 4 days disease, characterized by inferior eyelid reddish and edema in the left eye, with a fever
Summary
Two cases of eyelids Necrotizing Fasciitis in children were studied. The first case was a 7 years old girl who presented a necrotizing fasciitis in superior and inferior eyelids with a serious toxic shock as a complication of the chicken pox. Parenteral antibiotic treatment was not enough to stop the necrotizing process and surgical debriding was needed for the gangrenous tissues. In the eyelid culture Streptococcus pyogenes grew. A free skin graft was implanted to the inferior eyelid. The second case was presented in a 6 months old girl, who developed necrotizing fasciitis of her lower left eyelid without any trauma antecedent. An appropriate antibiotic coverage and management of systemic manifestations leads to a fast recovering; even though the developed necrosis demanded surgical debriding and a retroauricular free skin graft was performed later
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