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Periorbital necrotising fasciitis: delay in diagnosis results in loss of lower eyelid


Necrotising fasciitis (NF) is an extremely rare skin and soft tissue infection with extensive necrosis of the subcutaneous tissue and underlying fascia, which usually affects the limbs and trunk. It rarely affects the head and neck region because of the excellent blood supply in this region. We report a case of NF initially misdiagnosed as a traumatic pre-septal cellulitis following self-puncture of a hordeolum externum (stye) and its resistance to aggressive antibiotic therapy resulting in the loss of the lower eyelid.

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Fig. 1
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Necrotising fasciitis




Computerised Axial Tomography


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We would like to thank Mr. Brian Leatherbarrow , Mr. Saj Ataullah and Mrs. A.Cook, Consultant Ophthalmologists at Manchester Royal Eye Hospital for their expert management of this patient and photographs.

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Correspondence to Vignesh Raja.

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Raja, V., Job, R., Hubbard, A. et al. Periorbital necrotising fasciitis: delay in diagnosis results in loss of lower eyelid. Int Ophthalmol 28, 67–69 (2008).

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  • Necrotising fasciitis
  • Orbit
  • Trauma