Invasive streptococcal infection of the periorbita and forehead

Recent epidemiological reports suggest an increased frequency of invasive s treptococcal infections linked to the appearance of a dominant group A Stre ptococcus serotype. Necrotizing streptococcal infections involving the skin and soft tissues of the face are uncommon. This case demonstrates the aggr essive and invasive nature of these infections. The patient presented with symptoms of angioedema and was treated with corticosteroids. Her condition worsened and plastic surgery was consulted. There was extensive necrosis of the periorbital and forehead soft tissue, requiring extensive debridement to control the invasive process. Multiple reconstructive procedures were pe rformed to close the defects and to preserve function of the facial muscles and eyelids. The literature indicates less than 50 reported cases of necro tizing streptococcal infections limited to the periorbita. This case reflec ts the importance of rapid diagnosis, and emphasizes the need for prompt an d appropriate surgical treatment.