'Stalled' periocular necrotising fasciitis: early effective treatment or host genetic determinants?

Mutamba, A; Verity, D H; Rose, G E
March 2013
Eye;Mar2013, Vol. 27 Issue 3, p432
Academic Journal
BackgroundNecrotising fasciitis (NF) is a devastating disease with considerable mortality and morbidity, and early aggressive surgical debridement of devitalised necrotic tissues has traditionally been advocated.MethodsWe describe three patients who were referred from other units several weeks after developing periocular necrotising fasciitis; in all the three, the disease had been managed medically without surgical debridement, with apparent 'stalling' of the inflammatory process despite persistent necrotic periocular tissue.ResultsFollowing 'elective debridement' of the devitalised tissues and reconstruction with local flaps, all achieved a satisfactory aesthetic result.DiscussionThe role of host genetic determinants, polarised cytokine responses, and early, effective medical treatment in patients with atypical 'disease phenotypes' in NF are discussed.


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