A Tragic Case of Orbital Cellulitis in an Immunocompromised Patient

Immunocompromised patients are prone to opportunistic infections. Orbital infections are most likely to occur in advanced stages of acquired immunodeficiency syndrome (AIDS) and are associated with a high mortality rate, making prompt diagnosis and intervention critical. This case report describes a 42-year-old man, previously without known medical conditions, who presented to the Ophthalmology Department with a two-day history of swelling in his right eye. Additional symptoms included a productive cough with greenish sputum for two weeks and constitutional symptoms for one week. Examination revealed features of right orbital cellulitis and diminished optic nerve function. In addition, he had multiple tattoos all over his body with numerous pustules appearing on the forehead and lower limbs. He was clinically septic with rapidly deteriorating vital signs. Laboratory findings indicated a low total white cell count and neutropenia. Imaging studies disclosed lung and orbital abnormalities, and a rapid human immunodeficiency virus (HIV) test yielded a positive result. Despite aggressive treatment, the patient's clinical status rapidly declined, culminating in multiorgan failure and fatality. This case highlights a prompt recognition of orbital cellulitis in immunocompromised patients, which is imperative, as it may signify disseminated HIV infection and carry substantial morbidity and mortality risks.