Periorbital varicella gangrenosa, rare complication of chickenpox: a case report

Abstract

Periorbital varicella gangrenosa is an extremely rare and severe complication of varicella infection, with limited literature describing periorbital involvement. We report the first documented case from Bhutan involving a 4-year-old female child who presented with bilateral eyelid swelling, more severe on the left eye, following a recent varicella infection. A clinical diagnosis of left periorbital varicella gangrenosa was confirmed. The patient was managed through a multidisciplinary approach and underwent serial surgical debridement followed by split-thickness skin grafting. Despite extensive tissue loss due to delayed presentation, effective infection control was achieved, vision was preserved, and a satisfactory cosmetic outcome was obtained, although residual lagophthalmos persisted. This case highlights the importance of early recognition and aggressive multidisciplinary management to prevent severe morbidity and mortality.