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Haematospirillum jordaniae , a rare gram-negative bacterium, is emerging as a potential pathogen causing cellulitis and bacteremia in immunocompromised individuals. We present a case of a 49-year-old male patient with no comorbidities who developed cellulitis and bacteremia due to H. jordaniae . This case highlights the importance of considering H. jordaniae as a potential etiology in cellulitis and bacteremia. This organism is associated with bullous cellulitis of the lower extremities and bacteremia usually followed by abrasions when in contact with freshwater., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mada et al.)

Legionella pneumonia is a severe form of pneumonia caused by the bacterium Legionella pneumophila . It often presents with atypical symptoms and can lead to complications such as rhabdomyolysis and acute kidney injury (AKI). Here, we report a case of Legionella pneumonia-induced rhabdomyolysis and AKI in a 32-year-old male. Laboratory investigations revealed elevated creatinine kinase levels and acute kidney injury. Further investigation confirmed Legionella pneumonia. The patient was promptly treated with appropriate antibiotics and supportive care, resulting in clinical improvement and resolution of rhabdomyolysis and AKI. This case underscores the importance of considering Legionella pneumonia as a potential cause of rhabdomyolysis and AKI, especially in patients with atypical pneumonia presentations., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mada et al.)

Paenochrobactrum pullorum is a gram-negative bacterium and is not usually considered a human pathogen. This is the first case report of P. pullorum , highlighting the importance of understanding its clinical significance. The author reports a case of P. pullorum bacteremia from bilateral lower extremity wound infection., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Mada et al.)

Pneumomediastinum refers to the presence of air in the mediastinum (the space in the chest between the lungs). It can arise from various etiologies, including trauma, esophageal perforation, infections, medical procedures, or underlying lung diseases. Pneumocystis jirovecii pneumonia (PJP) is a common opportunistic infection seen in immunocompromised individuals, especially those with HIV/AIDS. Pneumomediastinum is a rare but serious complication of PJP that occurs in immunosuppressed patients, leading to significant morbidity and mortality. We present a rare case of pneumomediastinum caused by P. jirovecii pneumonia in an AIDS patient., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Mada et al.)

Group B Streptococcus endocarditis is a rare but serious condition, characterized by the infection of heart valves and associated with a high mortality rate. The emergence of antibiotic-resistant strains adds complexity to therapeutic strategies, emphasizing the importance of tailored antibiotic regimens and surgical interventions when indicated. Early diagnosis and multidisciplinary care are essential in improving patient outcomes. A 22-year-old male patient with no comorbidities was admitted with a thromboembolic stroke. MRI brain showed bilateral cerebral and cerebellar multifocal acute nonhemorrhagic infarcts. He was found to have Streptococcus agalactiae bacteremia, and infective mitral valve endocarditis. He underwent mitral valve replacement and IV antibiotic treatment with a successful outcome., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Mada et al.)

Hathewaya limosa , an anaerobic bacterium, has been associated with various infections, including prosthetic valve endocarditis, although its role in empyema remains uncommon. This abstract presents a case report of a patient diagnosed with H. limosa empyema, highlighting the clinical presentation, diagnostic challenges, and successful treatment strategies. The case underscores the importance of considering unusual pathogens in the context of empyema. We discuss the clinical management, microbiological identification, and outcomes of this rare infection to contribute valuable insights for healthcare practitioners encountering similar cases., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Mada et al.)

We describe an outbreak of Acinetobacter baumannii in a 15-bed regional burn unit in an academic tertiary care medical center, and the investigations and control measures used to halt the outbreak are described. Nine cases of A. baumannii were reported in our burn unit in a one-year period, which was higher than our expected number of two-three cases per year. Our burn unit director requested an outbreak investigation, and our hospital's infection control department investigated thoroughly and found a source for that outbreak, which was never reported as a source in the previous literature. We identified table fans as the source of this outbreak. We then developed a strict fan policy, and after implementation of the policy, and terminal cleaning of rooms, only two cases per year of A. baumannii were reported in the next three-year period. We concluded that the table fans were colonized with A. baumannii and since they were used interchangeably in all patient rooms, caused this outbreak. There are no specific joint commission guidelines for the use of fans in hospitals. While fans can be used for the comfort of the patient, we should be cautious not to spread infections., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mada et al.)

Primary pulmonary malignant melanoma (also called primary malignant melanoma of the lung, or PMML) is an exceedingly rare non-epithelial neoplasm, accounting for 0.01% of all primary lung cancers. We report a case of a 63--year--old male with no comorbidities who was found to have a large right lung upper lobe mass and was diagnosed with metastatic primary malignant melanoma of the lung. The outcome for primary pulmonary malignant melanoma is grim, with 5-year survival less than 20%, but many patients have rapid progression and a short life span, even with intervention., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mada et al.)

A 53-year-old female with a history of rheumatoid arthritis presented with acute-on-chronic shortness of breath. She had severe lung disease secondary to chronic obstructive pulmonary disease (COPD) and recurrent pneumonia. She was found to have recurrent methemoglobinemia and presented to the hospital with refractory hypoxemia. She was given intravenous (IV) methylene blue, and transfused 2 units of packed red blood cells. Her methemoglobin levels again trended up during hospitalization and after identifying and discontinuing the offending agent, an over-the-counter (OTC) benzocaine gel, her methemoglobin level was normalized and she never had a recurrence. The severity of presentation from methemoglobinemia is increased in patients with anemia, heart disease, and pulmonary disease., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mada et al.)

Background Due to the slow progression of many chronic liver diseases, including hepatitis C, it is not practical or safe to monitor disease progression by serial liver biopsies. Noninvasive laboratory scoring systems based on routine laboratory tests are appealing surrogate markers of liver fibrosis for the staging and monitoring of chronic liver diseases such as hepatitis C. Methods We explored the accuracy of three scoring systems: the fibrosis-4 score (FIB-4), the aspartate aminotransferase to platelet ratio index (APRI score), and the aspartate aminotransferase to alanine aminotransferase ratio (AAR) in 496 patients with chronic hepatitis C virus (HCV) infection who had undergone percutaneous liver biopsy at a viral hepatitis clinic in Shreveport, Louisiana. Results For FIB-4, the area under the receiver operating characteristic curve (AUROC) for hepatic fibrosis stages ≥ 1, ≥ 2, ≥ 3, and 4 (cirrhosis) ranged from 0.74 (95% CI, 0.678 - 0.802) to 0.802 (95% CI, 0.751 - 0.854). At a cutoff value of 1.45, FIB-4 was 82% sensitive for advanced fibrosis or cirrhosis (stage 3 or 4) but was only 58% specific for these findings. Increasing the FIB-4 cutoff value to 3.25 reduced the sensitivity for detecting advanced fibrosis or cirrhosis to 39%, but this higher cutoff was 92% specific for these findings. Corresponding AUROCs for the APRI and AAR scores were inferior to FIB-4. Conclusion The FIB-4 index outperformed APRI and AAR in our HCV infected population in predicting severe fibrosis or cirrhosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Mada et al.)