RT Journal Article SR Electronic T1 Extrapulmonary tuberculosis and COVID-19 infection coexisting in concurrent necrotising fasciitis with deep space infection of neck: an unusual presentation JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e250382 DO 10.1136/bcr-2022-250382 VO 15 IS 6 A1 Subham S Agarwal A1 Hafiz Md Nasimuddin Ansari A1 Santhosh Rao A1 Virat Galhotra YR 2022 UL http://casereports.bmj.com/content/15/6/e250382.abstract AB Ludwig’s angina is a rapidly spreading, potentially fatal infection of deep fascial spaces of the neck leading to airway oedema and death. This, in recent times when associated with COVID-19 infection, possess treatment challenges making the patient susceptible to opportunistic infections with reduced healing potential. Owing to the multifactorial aetiology in our case and addressing them at the earliest, it is important to achieve favourable outcomes. The space infection that seeded with untreated trivial dental caries progressed to necrotising fasciitis of neck with mycobacterial growth on cartridge-based nucleic acid amplification test for tuberculosis testing. The presence of Mycobacterium organisms should be speculated in patients with pulmonary signs of tuberculosis (TB) because a suppurative TB lymphadenitis of neck could also have the same presentation. The decisive moment in successful outcome was identification of mycobacteria in COVID-19 infected patient, thereby allowing to initiate the antitubercular therapy along with surgical debridement. Thus, medical management of patient with cohabiting infections is difficult task and needs appropriate addressal.