ABSTRACT
Eyelid necrosis is a very rare disease, usually secondary to trauma or infections. Pseudomonas aeruginosa [PA] eyelid necrosis remains principally a clinical diagnosis and it is often missed early in its presentation because of the difficulty in differentiating it from more common soft tissue infections. However, when the diagnosis is made we must act quickly due to the fatal evolution if not handled properly. We present the case of a non-neutropenic 53-year-old male patient with a history of alcoholism, smoking habit and lung cancer under chemotherapy treatment who developed ocular necrotizing fasciitis due to PA with perforation of his left eye and severe bilateral sclera ischemia despite intensive antibiotic treatment and surgical debridement.
Subject(s)
Humans , Male , Fasciitis, Necrotizing/microbiology , Pseudomonas aeruginosa , Pseudomonas Infections/complications , Conjunctivitis, Bacterial , Eyelid Diseases/microbiologyABSTRACT
Necrotizing fasciitis (NF) is a serious infection that compromises subcutaneous tissue, fascia, and adipose tissue, with high mortality rate and sequelae. Extremities, trunk and pelvis are the most common body sites affected. Periorbital celullitis with necrotizing fasciitis of the eyelid is rare. We report the case of a three years old child with bilateral NF of the eyelids and toxic shock syndrome secondary to Streptococcus pyogenes infection ocurring after a minor skin trauma. Early recognition leading to intensive care treatment and prompt surgical debridement were critical in the favourable outcome of the child.
La fascitis necrosante (FN) es una infección grave de los tejidos subcutáneos, localizada más frecuentemente en extremidades, tronco y pelvis. El compromiso de la cara y la región palpebral es inusual. Reportamos el curso clínico de un niño de tres años, previamente sano, que presentó una FN palpebral bilateral asociado a shock tóxico por Streptococcus pyogenes, secundaria a un trauma localizado. El paciente requirió tratamiento en cuidado intensivo con resucitación enérgica, antimicrobianos, inmunoglobulina intravenosa y desbridamiento quirúrgico precoz, lo que permitió su evolución favorable.
Subject(s)
Child, Preschool , Humans , Male , Eyelid Diseases/therapy , Fasciitis, Necrotizing/therapy , Streptococcus pyogenes , Shock, Septic/therapy , Streptococcal Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Debridement , Eyelid Diseases/diagnosis , Eyelid Diseases/microbiology , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/etiology , Immunoglobulins, Intravenous/therapeutic use , Severity of Illness Index , Shock, Septic/diagnosis , Shock, Septic/microbiology , Streptococcal Infections/diagnosis , Streptococcus pyogenes/isolation & purification , Treatment OutcomeABSTRACT
Relata-se o caso de uma paciente portadora de síndrome da imunodeficiência adquirida empiricamente tratada com esquema tríplice para tuberculose miliar. Durante a evolução clínica a paciente cursou com lesões comprometendo a pálpebra e conjuntiva tarsal à direita. A hipótese diagnóstica inicial foi de tuberculose ocular com comprometimento conjuntival e palpebral. A biópsia da lesão conjuntival mostrou presença do Criptococcus neoformans. Após o início do tratamento específico com anfotericina B, a paciente apresentou melhora das lesões cutâneas.
Subject(s)
Adult , Female , Humans , AIDS-Related Opportunistic Infections/complications , Cryptococcosis/complications , Eye Infections, Fungal/microbiology , Eyelid Diseases/microbiology , Conjunctiva/microbiology , Eye Infections, Fungal/pathology , Eyelid Diseases/pathologyABSTRACT
Os autores apresentam uma revisäo na literatura de Paracoccidioidomicose com comprometimento ocular