Work

Severe Periocular Inflammatory Reaction Mimicking Necrotizing Fasciitis following Hyaluronic Acid Microinjections: A Case Report and Literature Review

Year: 2026

Type: article

Abstract: Introduction: Hyaluronic acid (HA) fillers are widely utilized in esthetic medicine for facial rejuvenation, including in the periocular region. Although generally considered safe, severe inflammatory responses can occur. This report describes a case of a 42-year-old woman who developed a significant periocular reaction following HA microinjections, clinically resembling necrotizing fasciitis. Case Presentation: The patient, with no significant medical or ophthalmic history, presented to the emergency department with acute periocular swelling, redness, and an inability to open her right eye 3 h after HA microinjections. Clinical examination revealed marked periorbital edema, chemosis, and restricted ocular motility in the right eye. The severity of the presentation initially suggested necrotizing fasciitis. A CT scan indicated preseptal cellulitis without post-septal involvement. Treatment with intravenous antibiotics, systemic corticosteroids, antihistamines, and topical therapies led to significant improvement. Conclusion: This case highlights the need to recognize severe inflammatory reactions following periocular HA injections, which may mimic life-threatening conditions. Timely intervention and systematic evaluation are essential for achieving favorable outcomes.

Source: Case Reports in Ophthalmology

DOI: 10.1159/000551132

Authors: Tehila Shlomov, Nir Erdinest, Yossi Eshel, Zvi Gur

Institutions: Hebrew University of Jerusalem, Hadassah Medical Center

Language: English

Topic: Facial Rejuvenation and Surgery Techniques

Subfield: Dermatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,030