A RARE CASE OF TRIGEMINAL TROPHIC SYNDROME WITH PERIORBITAL CELLULITIS AND FULL THICKNESS UPPER EYELID DEFECT IN AN UNDIAGNOSED HIV PATIENT: A CASE REPORT

Abstract

Background Trigeminal Trophic Syndrome (TTS) is a rare cranial and facial condition caused by damage to the cen tral or peripheral branches of the trigeminal nerve. This syndrome consists of a triad of anesthesia, paresthesia and crescent-shaped facial ulcer involving the ala nasi and sometimes extending to the upper lip. Although previous screening for HIV in some patients with TTS was negative, we present a unique case of TTS who tested positive for HIV with eye complications. Case presentation We present a rare case of TTS in a 44-year-old black African woman who was tested positive for HIV. She presented with a 6-week history of progressive, persistent and painless left sided facial and scalp ulcera tions which started as small skin erosion. Diagnosis of TTS was made on clinical grounds based on the triad of anes thesia, paresthesia, unilateral crescent-shaped ulcer in the trigeminal dermatome and her past medical history. The ulcer healed completely after counseling and pharmacological therapy but she later developed left periorbital cel lulitis and left upper eyelid full thickness defect. Conclusion This is by far the first documented case of TTS with a positive HIV test. Testing for HIV in patients with TTS is necessary as this can help improve clinical management and treatment outcomes. Seeking the services of special ists remotely in resource constraint settings is beneficial for managing complications associated with TTS.