A 47-year-old man with a necrotic wound after trauma

Ophthalmology consultation was requested to evaluate right eyelid swelling on an intubated 47-year-old white man, with no significant past medical history or past ocular history, who was in the surgical trauma intensive care unit at Baylor Scott and White Health after a motorcycle accident, during which he was thrown into a ditch and suffered significant injuries to his left lower leg, which required amputation. He also had a 6 cm laceration across his right cheek, just under his right lower eyelid. This laceration was cleaned and repaired by another service prior to the patient being seen by ophthalmology. The patient had been hospitalized for 1 week between the time of his motorcycle accident and our consultation for eyelid swelling. Throughout his hospitalization, he maintained high fevers that were assumed to be caused by surgical complications of his traumatic leg wound. As a result, he was taken to the operating room for debridement and cleaning of the amputation wound multiple times, causing him to lose copious amounts of blood, which led to more than 30 transfusions of packed red blood cells over the first 2 weeks of his admission.