Case Report

Unusual cutaneous miliary tuberculosis manifesting as periorbital necrotizing fasciitis: Pitfalls and pearls


Mohamad Aizat Rosli1,2,3, Shawaltul Akhma Harun Nor Rashid3, Ahmad Sukari Halim1,2

1Hospital Universiti Sains Malaysia, Medical Campus. Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
2Reconstructive Sciences Unit, School of Medical Sciences, Medical Campus. Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
3Plastic and Reconstructive Unit, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia


Abstract


Periorbital Necrotizing fasciitis (NF) is a severe infection marked by progressive and rapid necrosis of superficial fascia, often caused by Group A Streptococcus. However, there are increasing reports of rare involvement of Mycobacterium tuberculosis in its pathogenesis. Failure to identify and commence appropriate treatment based on its pathogenesis can result in extensive facial disfigurement, blindness, meningitis, brain abscess, septicemia, and even death. This case report aims to highlight a number of salient points in managing a rare case of cutaneous miliary tuberculosis presenting as periorbital necrotizing fasciitis.

Keywords: bacterial skin diseases; miliary tuberculosis; necrotizing fasciitis