ArticleSurgical neurology international2026
The role of computed tomography scan in assessment of patient with herpes zoster opthalmicus complicated with periorbital necrotizing fasciitis.
Article in Surgical neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Periorbital necrotizing fasciitis (NF) is a severe form of soft-tissue infection characterized by necrosis of the subcutaneous tissue, muscle, and other deep soft tissue around the fascia in the periorbital region. Although rare, such a condition can occur following predisposing factors, such as injury from previous trauma, procedures, or infection. In this report, we highlight the role of preoperative computed tomography (CT) scan assessment in a patient with periorbital NF following herpes zoster ophthalmicus. Immunocompromised conditions, particularly human immunodeficiency virus (HIV) infection, increase the susceptibility to severe secondary bacterial infection and to the development of NF in the periorbital region. Case Description: A 31-years-old male, with HIV infection that had already taken antiretroviral therapy from about 1 month ago and history of chickenpox (varicella) at the age of 6 years old, presented with swelling and pain around his left eye from about 3 days ago, which the patient described it as sudden onset of multiple vesicles and bulla on the skin around his left eye that progressively worsened extending into the nose, left side of the forehead and upper lip with bluish discoloration and oozing secretion around the lesion, which make him unable to open his eye. He also had a history of varicella infection during childhood. The patient then underwent a head CT-scan, which revealed pre-septal and post-septal orbital cellulitis with multiple gas foci suggesting periorbital NF, along with involvement of the left ocular bulb; there was no sign of cavernous sinus thrombosis nor subperiosteal abscess. The patient then underwent surgical debridement and exenteration of the left eye. Conclusion: In our cases, head CT assessment in the cases of periorbital NF had a role in determining whether a surgical procedure should be taken with an ocular conservating approach or not, and to help in planning the extent of surgical debridement needed.
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