On initial examination, the periorbital area was swollen, erythematous and indurated, with desquamation of the lower lid. There were no orbital signs. The patient was mildly tachycardic but afebrile.

She was treated with intravenous antibiotics for suspected severe periorbital cellulitis. Despite treatment, the patient’s cellulitis progressed into necrotising fasciitis, and she was transferred for ...