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

AbstractBACKGROUND:
Necrotising fasciitis (NF) is a devastating disease with considerable mortality and morbidity, and early aggressive surgical debridement of devitalised necrotic tissues has traditionally been advocated.
METHODS:
We 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.
RESULTS:
Following 'elective debridement' of the devitalised tissues and reconstruction with local flaps, all achieved a satisfactory aesthetic result.
DISCUSSION:
The role of host genetic determinants, polarised cytokine responses, and early, effective medical treatment in patients with atypical 'disease phenotypes' in NF are discussed.
AuthorsA Mutamba, D H Verity, G E Rose
JournalEye (London, England) (Eye (Lond)) Vol. 27 Issue 3 Pg. 432-7 (Mar 2013) ISSN: 1476-5454 [Electronic] England
PMID23412558 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Bacterial Agents
Topics
  • Aged
  • Anti-Bacterial Agents (therapeutic use)
  • Blepharoplasty
  • Debridement
  • Eye Infections, Bacterial (drug therapy, genetics, surgery, therapy)
  • Eyelid Diseases (drug therapy, genetics, surgery, therapy)
  • Fasciitis, Necrotizing (drug therapy, genetics, surgery, therapy)
  • Female
  • Genetic Determinism
  • Humans
  • Male
  • Middle Aged
  • Orbital Diseases (drug therapy, genetics, surgery, therapy)
  • Pseudomonas Infections (drug therapy, genetics, surgery, therapy)
  • Streptococcal Infections (drug therapy, genetics, surgery, therapy)
  • Surgical Flaps
  • Th1 Cells (immunology)
  • Visual Acuity

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