Ganglionic tuberculosis complicated by periorbital aspergillosis in an infant: observation and literature review.

Introduction : Ganglionic tuberculosis is common in children in highly endemic areas such as Morocco. Locoregional extension to the cervico-facial and periorbital soft tissues remains rare, particularly in immunocompetent infants. We report an atypical case of periorbital co-infection with Mycobacterium tuberculosis and Aspergillus niger. Case report : An 18-month-old infant presented with a cervical swelling evolving over several months, with fistulization and periorbital extension. The diagnosis of tuberculosis was confirmed by the presence of acid-fast bacilli on direct examination and culture. At the same time, Aspergillus niger was isolated on two consecutive samples from the periorbital abscess, confirming co-infection. This identification enabled appropriate management combining antituberculosis and antifungal treatment, leading to a favorable outcome. Conclusion : This case highlights an atypical presentation of extrapulmonary tuberculosis, associated with periorbital aspergillosis in an immunocompetent infant. It highlights the importance of a full etiological diagnosis, including mycological examination, in the face of any prolonged necrotic lesion, in order to adapt management early and avoid complications.