PDF(Pubmed)
Abstract：
(1) Background: Necrotizing fasciitis (NF) is a severe and aggressive pathology with a rapid progression and high mortality risk. Periocular NF is a rare condition associated with a lower mortality risk but significantly higher disabling sequelae. (2) Methods: We present the case of a 67-year-old homeless patient, a victim of assault, with multiple untreated comorbidities (diabetes mellitus, cardiac conditions, and schizophrenia) and a delayed diagnosis of periocular necrotizing fasciitis. The condition showed a cyclical evolution influenced by the existing comorbidities, and the patient underwent both surgical and medical treatment with a multidisciplinary team. Additionally, we report a systematic review of cases from the literature. (3) Results: The patient\'s survival outcomes were favorable; however, the sequelae were disabling, not only concerning aesthetic aspects but also due to the loss of the affected eye globe. The systematic review revealed the rarity of such cases and the peculiarities of the presented case compared to those reported in the literature up to this point. (4) Conclusions: Understanding the signs, symptoms, and predisposing factors, as well as the potential rare localizations of NF, including the periocular region, can lead to the early diagnosis and treatment with good functional and aesthetic outcomes, minimizing significant disabilities.
摘要：
（1）背景：坏死性筋膜炎（NF）是一种严重且侵袭性的病理，进展迅速，死亡风险高。眼周NF是一种罕见的疾病，死亡率较低，但致残后遗症明显较高。（2）方法：我们介绍了一名67岁的无家可归患者的情况，袭击的受害者,患有多种未经治疗的合并症（糖尿病，心脏病,和精神分裂症）和眼周坏死性筋膜炎的延迟诊断。病情表现出周期性演变，受现有合并症的影响，患者接受了多学科团队的手术和药物治疗。此外,我们对文献中的案例进行了系统回顾。(3)结果：患者的生存结果良好；然而，后遗症是致残的，不仅涉及美学方面，而且由于受影响的眼球的损失。与迄今为止的文献报道相比，系统审查揭示了此类病例的稀有性和所提出病例的特殊性。（4）结论：了解体征，症状,和诱发因素，以及NF的潜在罕见定位，包括眼周区域，可以导致早期诊断和治疗，具有良好的功能和美学效果，尽量减少严重的残疾。
