STREPTOCOCCAL NECROTIZING FASCIITIS COMPLICATING A CONJUNCTIVAL DACRYOCYSTORHINOSTOMY

Necrotizing fasciitis is a rare infection of the deep and subcutaneous tissue layers most commonly caused by group A beta-hemolytic Streptoc occus. The disease begins as a typical cellulitis. Necrosis of the dee per tissues progresses rapidly, accompanied by a dusky, gray-blue skin discoloration with erythematous margins. Even with appropriate treatm ent, mortality rates remain as high as 36%. Most cases of necrotizing fasciitis have been reported in the general surgical literature, assoc iated with trauma or as a postoperative wound infection after abdomina l and gynecologic procedures. Of the 50 cases involving the eyelids re ported in the literature, only three were reported to have occurred as a ''postoperative'' complication. This report is of the first known c ase of streptococcal necrotizing fasciitis complicating a conjunctival dacryocystorhinostomy.