{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:56:26Z","timestamp":1767192986115,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"12","funder":[{"name":"Hector MacLean CERA","award":["2020-2021 fellowship. No award number"],"award-info":[{"award-number":["2020-2021 fellowship. No award number"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,11,25]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:p>A previously independent 56-year-old immunocompetent woman presented with septic shock in the setting of periorbital swelling and diffuse infiltrates on chest imaging. Blood cultures were positive for growth of group A <jats:italic>Streptococcus<\/jats:italic> (GAS). Broad spectrum antimicrobials were initiated with the inclusion of the antitoxin agent clindamycin. Necrosis of periorbital tissue was noted and surgical consultation was obtained. D\u00e9bridement of both eyelids with skin grafting was performed. GAS was isolated from wound cultures and also observed on periorbital tissue microscopy. The final diagnosis was bilateral periorbital necrotising fasciitis (PONF) associated with invasive GAS infection. The patient had a prolonged intensive care unit course with input from multiple specialist teams. This case demonstrates the importance of early recognition and treatment of PONF, the profound systemic morbidity caused by these infections, and illustrates successful multidisciplinary teamwork.<\/jats:p>","DOI":"10.1136\/bcr-2020-236800","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T18:18:21Z","timestamp":1608661101000},"page":"e236800","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Bilateral periorbital necrotising fasciitis associated with invasive group: a <i>Streptococcus<\/i> infection"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3757-7749","authenticated-orcid":false,"given":"Grace Anne","family":"McCabe","sequence":"first","affiliation":[{"name":"Ophthalmology, Royal Melbourne Hospital, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Hardy","sequence":"additional","affiliation":[{"name":"Ophthalmology, Royal Melbourne Hospital, Melbourne, Victoria, Australia"},{"name":"Orbital Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4508-0089","authenticated-orcid":false,"given":"Thomas Gordon","family":"Campbell","sequence":"additional","affiliation":[{"name":"Ophthalmology, Royal Melbourne Hospital, Melbourne, Victoria, Australia"},{"name":"Department of Surgery, University of Melbourne and Centre for Eye Research Australia, East Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"key":"2025082623331001000_13.12.e236800.1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2013-304735"},{"key":"2025082623331001000_13.12.e236800.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00576-0"},{"key":"2025082623331001000_13.12.e236800.3","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1038\/eye.2012.285","article-title":"\u2018Stalled\u2019 periocular necrotising fasciitis: early effective treatment or host genetic determinants?","volume":"27","author":"Mutamba","year":"2013","journal-title":"Eye"},{"key":"2025082623331001000_13.12.e236800.4","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2009.167486"},{"key":"2025082623331001000_13.12.e236800.5","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2015-307445"},{"key":"2025082623331001000_13.12.e236800.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-3768.2012.02420.x"},{"key":"2025082623331001000_13.12.e236800.7","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-224436","article-title":"A rare cause of periorbital swelling","volume":"345","author":"Leach","year":"2018","journal-title":"BMJ Case Rep"},{"key":"2025082623331001000_13.12.e236800.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(02)01257-5"},{"key":"2025082623331001000_13.12.e236800.9","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9371"},{"key":"2025082623331001000_13.12.e236800.10","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/SLA.0000000000002774","article-title":"Necrotizing soft tissue infection","volume":"269","author":"Fernando","year":"2019","journal-title":"Ann Surg"},{"key":"2025082623331001000_13.12.e236800.11","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/eye.2011.241","article-title":"Multidisciplinary management of periocular necrotising fasciitis: a series of 11 patients","volume":"26","author":"Tambe","year":"2012","journal-title":"Eye"},{"key":"2025082623331001000_13.12.e236800.12","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy401"},{"key":"2025082623331001000_13.12.e236800.13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199601253340407"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-236800","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:33:20Z","timestamp":1756276400000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-236800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":13,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,21]]},"published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1136\/bcr-2020-236800"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-236800","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,12]]}}}