Necrotizing Fasciitis Following Herpes Zoster Ophthalmicus in an Immunocompromised Patient

Table 1

Comparison between three cases of periorbital NF following cutaneous herpes zoster.

	Case 1	Case 2	Case 3 (present)
Age (yrs)/Gender	53/M	63/F	70/F
Immune System	Immunodepressed	Immunocompetent	Immunosuppressed
History of ocular diseases	No	No	2 previous keratoplasties for herpetic keratitis
General risk factors	Alcohol abuse	Discoid Lupus Erythematosus	Waldenström’s Macroglobulinemia
Local risk factors	Periocular shingles lesions, recent eyelid trauma	Periocular shingles lesions	Periocular shingles lesions
Periorbital skin lesions localization	Right lower eyelid	Upper eyelids	Left upper eyelid
Wound Culture Results	Group A β-haemolytic streptococcus, staphylococcus aureus	Group A β-haemolytic streptococcus	Group A β-haemolytic streptococcus
History of Septic Shock	No	No	Yes
Time btw. diagnosis of periorbital cellulitis and development of NF	8 days	18 hours	2 hours
Systemic Antibiotic Treatment	Co-amoxiclav and acyclovir	Clindamycin, ciprofloxacin and acyclovir	Imipenem/cilastatin, clindamycin, linezolid and acyclovir
Surgical Debridement	Debridement, reconstructive full-thickness skin grafting to the lower lid	Debridement, full-thickness skin grafting to the upper lids	Debridement, fasciotomy
Outcome	Survived; donor and graft sites healthy.	Survived; donor and graft sites healthy.	Died.