Blastocystis species in hepatic abscesses: innocent bystander or hidden culprit? A case report and literature review

First Report of Fatal Disseminated Blastomyces percursus Infection in a Liver Transplant Recipient in Iran, a Non-endemic Country: A Case Report

[The hidden infection: nocardiosis with multiple extra pulmonary foci].

Emerging Threat of Mucormycosis in the COVID-19 Era: A Review of Epidemiology, Risk Factors, and Therapeutic Strategies

Mucormycosis is a rare but very aggressive invasive fungal infection that has emerged as a major opportunistic infection during the COVID-19 pandemic, particularly in immunocompromised patients. The term “black fungus” is used for a group of fungi known as Mucorales such as Rhizopus, Mucor, Lichtheimia, and Apophysomyces species. Uncontrolled diabetes mellitus, extensive use of corticosteroids, lengthy intensive care unit (ICU) stay, and exposure to contaminated medicine, including oxygen delivery systems, were largely blamed for the sudden surge in cases, especially in India. There is rapid angioinvasion in mucormycosis, causing vascular thrombosis and necrosis, which can result in high mortality when diagnosis and treatment is delayed. The clinical manifestations are rhino-orbito-cerebral, pulmonary, cutaneous, gastrointestinal, and disseminated mucormycosis. A high degree of clinical suspicion with imaging studies, histopathological examination, and advanced molecular studies like polymerase chain reaction and internal transcribed spacer sequencing are necessary for accurate diagnosis. Management strategies emphasize early initiation of antifungal therapy, most commonly liposomal amphotericin B, posaconazole, or isavuconazole, alongside aggressive surgical debridement when indicated. In recent clinical trials, isavuconazole is highly effective and less toxic compared to other azoles. This review highlights the significance of a multidisciplinary approach, increased awareness among high-risk groups, and continued epidemiological monitoring for future outbreaks. Continuous efforts are required to improve the diagnostic capacity and preparedness for public health in order to lower the burden of mucormycosis in the world.

Rare primary small intestinal infection: a case report of Mycobacterium kansasii enteropathy in an immunocompetent patient and literature review.

BACKGROUND Non-tuberculous mycobacteria (NTM) are important opportunistic pathogens that most commonly infect the lungs. Primary involvement of the gastrointestinal tract-especially the small intestine-is exceedingly rare, and small-bowel infection caused by Mycobacterium kansasii (M. kansasii) has seldom been reported. CASE PRESENTATION We describe an extremely rare case of primary small-intestinal M. kansasii infection in an immunocompetent young man who presented with prolonged chronic diarrhea and fever. After an extensive but unrevealing diagnostic work-up, the etiology was finally established by microbial metagenomic sequencing of tissue obtained by double-balloon endoscopy. Building on the initial regimen of ethambutol hydrochloride, rifampicin, and clarithromycin-and with subsequent antibiotic adjustments tailored to the patient's evolving symptoms-clinical symptoms resolved completely, and follow-up endoscopy showed mucosal improvement. CONCLUSION This case underscores that NTM infection should be considered in the differential diagnosis of unexplained chronic gastrointestinal symptoms and highlights the pivotal role of modern molecular techniques in reaching a precise diagnosis. Detailed analysis of the case together with a review of the literature aims to raise clinicians' awareness and improve management of this rare entity.

Hypervirulent Klebsiella pneumoniae ST23 causing pyogenic liver abscess and metastatic endogenous endophthalmitis in Europe: a case report

Pyogenic liver abscess (PLA) has traditionally been considered prevalent in Asia. However, its incidence is increasing in Europe. Klebsiella pneumoniae (Kp) has emerged as the leading causative pathogen, and hypervirulent strains pose a higher risk of invasive disease and metastatic complications, such as endogenous endophthalmitis (EE). The case describes a 77-year-old woman who presented with fever and right upper quadrant abdominal pain. She was diagnosed with a second episode of PLA within 3 months, caused by Kp. Despite prompt antimicrobial therapy and percutaneous transhepatic drainage, the patient developed acute vision loss in the left eye during hospitalization. Ophthalmologic assessment confirmed EE secondary to bacteremia. Whole-genome sequencing identified the isolate as hypervirulent Kp (hvKp) sequence type 23 (ST23). While the liver abscess resolved following treatment, the patient sustained permanent loss of vision in the affected eye despite aggressive medical and surgical management. This case illustrates the invasive nature of hvKp and its potential for recurrence and metastatic complications. Improved recognition through targeted virulence testing is essential to avoid underdiagnosis. This case highlights the aggressive nature of hvKp. Early recognition of systemic and ocular symptoms, prompt ophthalmologic evaluation, and timely source control are essential. Optimal management requires multidisciplinary collaboration and the use of molecular diagnostics, including whole-genome sequencing, to identify hypervirulent lineages and support surveillance.

Cutaneous cryptococcosis with atypical location in a cat - case report

ABSTRACT Cryptococcosis is a rare systemic mycosis among pathogenic fungi, yet it is recognized for its clinical importance in felines. This paper reports on a clinical case of cutaneous cryptococcosis in a domestic cat (Felis catus), presenting a single lesion on the abdominal wall, without ulceration, an uncommon presentation in veterinary literature. The 7-year-old cat had normal laboratory parameters, which contrast with most reports of systemic fungal infections. Diagnosis was based on cytology obtained through fine-needle aspiration (FNA), stained with Panoptic stain and complemented by the India ink technique, highlighting the polysaccharide capsule of Cryptococcus spp. Antifungal therapy with itraconazole and fluconazole, both administered orally, was initiated. Despite early treatment, the cat died of cardiorespiratory arrest on the fourth day of hospitalization. This report emphasizes the importance of early diagnosis, even in atypical clinical presentations, and highlights cytology with specific staining as an accessible and effective diagnostic tool, as well as alerting to the possibility of fulminant disease progression even in the absence of evident clinical and laboratory changes.