Demodex Folliculorum Causing Necrotizing Fasciitis in a Patient of Autoimmune Myelofibrosis and Type 2 Diabetes: A Rare Case Report.

Demodicosis is a skin disease caused by the Demodex mite. It commonly involves areas in or near pilosebaceous units. Infestation with Demodex is asymptomatic but may have a pathogenic role in immunocompromised individuals or when present in high densities. We hereby report a case of a 36-year-old fruit seller, a known case of diabetes, rheumatic heart disease, and autoimmune myelofibrosis, who presented with progressive right periorbital swelling with blackish discoloration, purulent discharge, and fever. Incision and debridement were performed repeatedly, and tissue was sent for microbiology, which revealed Demodex folliculorum. The patient was treated with IV antibiotics, IV amphotericin B empirically, and oral ivermectin for Demodex.