Facial nerve abscess in a case of leprosy - a case report

A 14-year old boy presented with lagophthalmos of the left eye for ten days. Physical examination revealed a hypo-pigmented macule on the left cheek and a nodular fluctuant swelling in the left pre-auricular region. A skin biopsy showed evidence of borderline tuberculoid Hansen's disease and the lepromin test was positive. The swelling was diagnosed to be a facial nerve abscess. He was started on tapering doses of corticosteroids and World Health Organization pauci-bacillary multi drug therapy. The swelling subsided over the next one month and the facial paralysis improved gradually with treatment.