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56-year-old man presents to UK hospital with swollen eye from flesh-eating bacterial infection

A patient started vomiting blood and experienced liver failure after initially presenting at Royal Devon and Exeter Hospital with a painful right eye

Brain

A patient sought treatment at Royal Devon and Exeter Hospital after experiencing pain in his right eye and lower eyelid soft tissue swelling.

Despite treatment with intravenous antibiotics, the swelling progressed and the man developed septic shock.

The 56-year-old man was found to have the flesh-eating bacterial condition, periorbital necrotising fasciitis, and previously undiagnosed hepatitis C.

The patient underwent surgery to remove the unhealthy tissue and was treated with intravenous antibiotics and immunoglobulins.

“The patient was effectively managed by early involvement of multiple clinical teams,” clinicians highlighted in BMJ Case Reports.

The authors noted that necrotising fasciitis is a rare soft tissue condition with a high mortality rate. There are around 500 cases each year in the UK.

The clinicians shared that involvement of the face and periorbital area is rare in necrotising fasciitis because of efficient blood supply to these areas.

“Untreated, periorbital necrotising fasciitis typically results in rapid tissue destruction and may lead to visual loss, usually two to four days following initial infection,” they noted.

Image credit: BMJ Case Reports 2019