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BJO Online First, published on June 3, 2014 as 10.1136/bjophthalmol-2013-304735 Global issues
Incidence of periorbital necrotising fasciitis in the UK population: a BOSU study P W Flavahan,1 P Cauchi,1 M E Gregory,1 B Foot,2 S R Drummond1 1
Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK 2 British Ophthalmological Surveillance Unit, London, UK Correspondence to Dr Paul Flavahan, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Great Western Road, Glasgow G12 0YN, UK; paulfl[email protected] Received 2 December 2013 Revised 31 March 2014 Accepted 13 May 2014
ABSTRACT Background Periorbital necrotising fasciitis (PNF) is a devastating infection of subcutaneous soft tissue and underlying fascia causing severe morbidity and even loss of life. Few case reports of PNF exist and there are no prospective epidemiological studies. Methods A prospective observational study was undertaken using the British Ophthalmological Surveillance Unit reporting system. Questionnaires were sent to reporting ophthalmologists in the UK seeking cases of PNF over a 2-year period. Results 30 new cases were confirmed. 16 of the reported cases followed a precipitating event, 9 cases followed trauma and 3 followed surgery. β-haemolytic Streptococcus A was the causative organism identified in 76%, either alone or with concurrent infection, and antibiotic sensitivities are discussed. Systemic complications occurred in the majority of cases (66.6%), with sepsis and death occurring in 10%. Over 50% of surviving patients had subsequent morbidity, reduced acuity (
BJO Online First, published on June 3, 2014 as 10.1136/bjophthalmol-2013-304735 Global issues
Incidence of periorbital necrotising fasciitis in the UK population: a BOSU study P W Flavahan,1 P Cauchi,1 M E Gregory,1 B Foot,2 S R Drummond1 1
Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK 2 British Ophthalmological Surveillance Unit, London, UK Correspondence to Dr Paul Flavahan, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Great Western Road, Glasgow G12 0YN, UK; paulfl[email protected] Received 2 December 2013 Revised 31 March 2014 Accepted 13 May 2014
ABSTRACT Background Periorbital necrotising fasciitis (PNF) is a devastating infection of subcutaneous soft tissue and underlying fascia causing severe morbidity and even loss of life. Few case reports of PNF exist and there are no prospective epidemiological studies. Methods A prospective observational study was undertaken using the British Ophthalmological Surveillance Unit reporting system. Questionnaires were sent to reporting ophthalmologists in the UK seeking cases of PNF over a 2-year period. Results 30 new cases were confirmed. 16 of the reported cases followed a precipitating event, 9 cases followed trauma and 3 followed surgery. β-haemolytic Streptococcus A was the causative organism identified in 76%, either alone or with concurrent infection, and antibiotic sensitivities are discussed. Systemic complications occurred in the majority of cases (66.6%), with sepsis and death occurring in 10%. Over 50% of surviving patients had subsequent morbidity, reduced acuity (
