Abstract

Periorbital necrotizing fasciitis (NF) is a rare, rapidly progressing condition with significant systemic impact. We report the case of a 44-year-old healthy woman who developed acute left upper eyelid swelling, initially presented with a left ear infection that was treated with topical measures elsewhere. The condition recurred and extended to the eye, exacerbated by a recent childbirth and increased stress from a demanding job. Imaging revealed periorbital edema without intraocular or intracranial spread. Despite initial empirical treatment, the swelling extended to the contralateral eye within 48 h, accompanied by skin sloughing and necrotic margins, necessitating urgent surgical debridement. Cultures identified Streptococcus pyogenes and herpes simplex virus 1 (HSV-1), and histopathology confirmed extensive necrosis and inflammation. Treatment was adjusted based on culture and sensitivity results, leading to significant improvement. Vision remained unaffected, although cicatricial ectropion and lagophthalmos were expected and managed with subcutaneous mixture of triamcinolone and 5-fluorouracil injections, with future plans for skin grafting. This case highlights the unusual presentation of periorbital NF induced by HSV infection in a healthy young woman. The paper emphasizes the need for early recognition, immediate surgical intervention, and meticulous investigation to reduce progression and minimize morbidity in this rare and clinically challenging condition.

Keywords

Publication details

DOI
10.4103/ojo.ojo_255_24
Journal
Oman Journal of Ophthalmology, 18(3), 378-381
Publisher
Medknow Publications
Open access
Gold open access

Cite this article

APA 7

Al Ghaithi, H., Al Ghafri, A., Rizvi, S., Al Hadabi, A., Al Jabri, N., Al Moqbali, H., & Al Shaaib, M. (2025). Periorbital necrotizing fasciitis post herpes simplex virus infection: A rare case report. Oman Journal of Ophthalmology, 18(3), 378-381. https://doi.org/10.4103/ojo.ojo_255_24

MLA 9

Al Ghaithi, Houda, et al. "Periorbital necrotizing fasciitis post herpes simplex virus infection: A rare case report." Oman Journal of Ophthalmology, vol. 18, no. 3, 2025, pp. 378-381. https://doi.org/10.4103/ojo.ojo_255_24.

Chicago (author–date)

Al Ghaithi, Houda, Alyaqdhan Al Ghafri, Syed Rizvi, Abir Al Hadabi, Noor Al Jabri, Huda Al Moqbali, and Mustafa Al Shaaib. 2025. "Periorbital necrotizing fasciitis post herpes simplex virus infection: A rare case report." Oman Journal of Ophthalmology 18 (3): 378-381. https://doi.org/10.4103/ojo.ojo_255_24.

Harvard

Al Ghaithi, H., Al Ghafri, A., Rizvi, S., Al Hadabi, A., Al Jabri, N., Al Moqbali, H. and Al Shaaib, M. (2025) 'Periorbital necrotizing fasciitis post herpes simplex virus infection: A rare case report', Oman Journal of Ophthalmology, 18(3), pp. 378-381. doi:10.4103/ojo.ojo_255_24.

Vancouver

Al Ghaithi H, Al Ghafri A, Rizvi S, Al Hadabi A, Al Jabri N, Al Moqbali H, et al. Periorbital necrotizing fasciitis post herpes simplex virus infection: A rare case report. Oman Journal of Ophthalmology. 2025;18(3):378-381. doi:10.4103/ojo.ojo_255_24

IEEE

H. Al Ghaithi, A. Al Ghafri, S. Rizvi, A. Al Hadabi, N. Al Jabri, H. Al Moqbali, and M. Al Shaaib, "Periorbital necrotizing fasciitis post herpes simplex virus infection: A rare case report," Oman Journal of Ophthalmology, vol. 18, no. 3, pp. 378-381, 2025, doi: 10.4103/ojo.ojo_255_24.