Statistics from Altmetric.com
Fewer than 50 cases of invasive group A streptococcal (iGAS) eyelid infections have been reported.1 Predisposing factors include skin trauma or surgery2–7 and immunosuppression.3,4 iGAS preseptal cellulitis can be devastating; potentially leading to streptococcal gangrene of the eyelids,1 which can be fatal with a mortality of 40% in the presence of bacteraemia, and an overall mortality of 18%.1
An 80 year old man with rheumatoid arthritis presented with rapidly spreading periorbital erythema involving both eyes within 12 hours, having started at the left pinna which was markedly swollen and discharging (fig 1).
Empirical treatment was begun for possible necrotising streptococcal infection with clindamycin 900 mg four times daily and imipenem 500 mg four …
The authors have no financial interest in the products discussed.
The patient has given full verbal and written consent for publication of the case and of the included photographs and scan image.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.