Necrotizing fasciitis of the face triggered by a neglected hordeolum: a case report and literature review
- Author:
Soo Hyun WOO
1
;
Su Yong KIM
;
Il Young AHN
;
Tae Hui BAE
;
Shin Hyuk KANG
;
Woo Ju KIM
;
Han Koo KIM
Author Information
- Publication Type:Case Report and Literature Review
- From:Archives of Craniofacial Surgery 2026;27(1):34-39
- CountryRepublic of Korea
- Language:English
- Abstract: Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft tissue infection that rarely involves the periorbital region. We report an unusual case of periorbital NF caused by methicillin-sensitive Staphylococcus aureus (MSSA) in a previously healthy 48-year-old woman, originating from a neglected, recurrent hordeolum—an otherwise benign eyelid condition. The infection resulted in an extensive fullthickness defect of the upper eyelid and adjacent temporal area, presenting major reconstructive challenges. Reconstruction was performed using a radial forearm free flap combined with a buccal mucosal graft to restore both anterior and posterior lamellae, achieving functional eyelid protection and improved visual acuity. This case highlights the potential for seemingly minor, recurrent eyelid infections to progress rapidly to devastating NF even in the absence of systemic symptoms or risk factors. Early recognition and multidisciplinary management were critical to preventing further morbidity. To our knowledge, MSSA has not previously been reported as a causative agent of periorbital NF, underscoring the need for clinical vigilance and timely intervention in common eyelid conditions to avoid catastrophic complications.
