Opportunistic infections are an important cause of death and morbidity among HIV infected patients. Disseminated infections by nontuberculous mycobacteria are a diagnostic to consider among these patients with a high level of immunosuppression. A 64 year old Caucasian man, born in Angola, living in Portugal since 1975, presented in the emergency room with generalized malaise, weight loss, vesperal temperatures of around 37.5 °C with night sweats for two months, and epigastric abdominal pain with liquid stools in the 2 previous weeks. Laboratory study revealed a previously undiagnosed HIV-1 infection with 42 Lymphocytes CD4+/uL and viremia of 61,249 copies/mL. The abdominal-pelvic CT scan showed multiple necrotic ganglia in the mesenterium and mesenteric vases, which were biopsied revealing positive PCR for a nontuberculous mycobacteria; duodenal biopsies showed similar results. The bone marrow blood culture yeald the growth of Mycobacterium genavense. Antimicobacterial treatment was started and after six months he showed imagiological deterioration and the antibiogram revealed resistance to all antimycobacterial agents. The therapeutic scheme was empirically changed and the patient kept under vigilance with chronic therapy. This rare clinical case is both a diagnostic and therapeutic challenge.Tuberculosis remains a worrying public health problem. But if pulmonary tuberculosis’s symptomatology is well known by the medical profession, this is not the case of genital tuberculosis. We take advantage of a case of vaginal tuberculosis to review the international literature about clinical diagnosis, further tests, and treatment of this extremely rare tuberculosis localization.We herein report a case of primary sternal osteomyelitis caused by polymicrobial bacteria, including Actinomyces israelii. A 72-year-old man presented with a fever and precordial pain. Chest computed tomography (CT) revealed peristernal fluid associated with an osteolytic lesion and a peripheral nodule in the right upper lobe. We suspected sternal osteomyelitis, and an incision and drainage were performed. Culture of the drainage fluid and bone tissue yielded A. israelii, Fusobacterium necrophorum, and Streptococcus constellatus. Treatment with benzylpenicillin potassium (PCG) was administered. A subsequent chest CT scan showed that the peripheral nodule decreased in size after antimicrobial therapy. We therefore presumed the peripheral nodule as septic pulmonary embolism(SPE). Antimicrobial agents were administered for a total of 6 months. To our knowledge, this is the first case report of primary sternal osteomyelitis associated with presumed SPE caused by polymicrobial bacteria, including A. israelii. It is important to identify the causative pathogen in osteomyelitis, which requires long-term antibiotic treatment.The current global pandemic of COVID-19 disease is caused by a novel coronavirus SARS-CoV-2. This typically causes severe respiratory illness, however, as cases have multiplied across the globe, protean manifestations involving multiple organ systems have been described. We report a case of a 35-year-old woman with meningoencephalitis associated with COVID-19 disease who presented with altered mental status and rhythmic limb movements. Although rare, meningoencephalitis should be considered as a possible manifestation of COVID-19 disease.Infective endocarditis caused by Neisseria meningitidis (NM) is a very rare manifestation of invasive meningococcal disease with only a few cases described in the literature. We report a case of a native mitral valve endocarditis caused by NM in a 61-year-old female without meningitis. Our case highlights the importance of considering NM as one of the causative organisms of infective endocarditis, even in the absence of meningitis. Even though the cases of NM endocarditis have drastically decreased with the advent of antibacterials, NM should always be considered in the differential diagnosis in certain high-risk groups, like diabetics, polysubstance abusers, and elderly individuals. The prognosis is good with early appropriate antibiotic treatment with or without surgery.Brain abscesses are an uncommon but potentially fatal infection. They can spread directly from an adjacent source or hematogenously from a distant source. Encephaloceles represent a rare form of neural tube defects that can potentially be complicated by the development of meningitis or brain abscess. We report a case of a 63-year-old female who presented with bilateral lower extremity weakness and was ultimately found to have a Streptococcus pneumoniae subdural empyema and an associated frontal lobe encephalocele extending through the left frontal sinus. She was treated with surgical drainage, intravenous antimicrobials, and ultimately surgical repair of the encephalocele. This report highlights a unique presentation of brain abscess. Clinicians should be aware of this potential infectious complication of a neural tube defect.

species belong to the class Zygomycetes and order Mucorale. These are found in the environment and tropical soil, usually presenting as colonizers and rarely cause human infection.

is a species of the genus

and is the most commonly identified pathogen. Most cases are reported in immunocompromised individuals, such as patients on long term steroids, poorly controlled diabetes, or patients with malignancy.

We are describing two cases of rare fungal infection by

species causing invasive pulmonary manifestation. Both patients had compromised immune status and presented with worsening dyspnea to the emergency room. Both had signs and symptoms of bilateral worsening pneumonia evident by chest X-ray showing bilateral pulmonary infiltrates.

species were isolated from sputum cultures. Deoxycholate amphotericin B was started and the response was monitored. One patient expired while the other improved.

species belong to class Mucormycosis, rarely causing invasive infection but when they do outcome is potentially fatal. Very few cases are reported worldwide so the clinical course is still unclear. To the best of our knowledge, these are the first two cases to be reported from Pakistan.

These two cases describe pneumonia as a result of concomitant infection by rare fungal species

and MRSA in immunocompromised patients. Few cases are reported so limited data is available to understand complete disease implications. Citarinostat HDAC inhibitor Mucormycosis is a therapeutic challenge because of the phylogenetic diversity, un-availability of any serological testing and invasive disease pattern.

These two cases describe pneumonia as a result of concomitant infection by rare fungal speciesSyncephalastrum and MRSA in immunocompromised patients. Few cases are reported so limited data is available to understand complete disease implications. Mucormycosis is a therapeutic challenge because of the phylogenetic diversity, un-availability of any serological testing and invasive disease pattern.