Severe Mpox Infections in People With Uncontrolled Human Immunodeficiency Virus.

In the current mpox outbreak, infections are usually self-limited. We describe 3 patients with uncontrolled HIV and mpox infections lasting months, causing debilitating lesions, complications, and death, despite initiating anti-mpox and antiretroviral therapy. Delayed treatment of mpox with antiviral agents may contribute to poor outcomes in severely immunocompromised patients.

A Case of Polymicrobial, Gram-Negative Pulmonic Valve Endocarditis.

Infective endocarditis due to Gram-negative, non-HACEK bacteria is a rare clinical entity. Even moreso, isolated pulmonic valve endocarditis accounts for less than 1.5-2% of all cases of infective endocarditis. These disease pathologies commonly occur in the setting of intravenous drug abuse, indwelling catheters or cardiac devices, or underlying structural heart disease. We present a unique case of pulmonic valve endocarditis in the setting of persistent polymicrobial bacteremia with Klebsiella pneumoniae and Citrobacter koseri with recent gastrointestinal instrumentation evolving into isolated pulmonic valve endocarditis.

The First Reported Case of Majocchi's Granuloma with Malbranchea sp. in an Immunocompetent Patient.

Majocchi's granuloma is a rare condition in which a dermatophyte invades the deeper layers of the dermis and subcutaneous tissue and can often be misidentified and treated as eczema. It has a variable presentation ranging from cutaneous lesions to deeper infections in immunocompromised patients. No prior cases have described the formation of Majocchi's granuloma with the deuteromycetes, Malabranchea.

Sporotrichoid-Like Spread of Cutaneous Mycobacterium chelonae in an Immunocompromised Patient.

Mycobacterium chelonae is a rapidly growing mycobacterium found in water and soil that can cause local cutaneous infections in immunocompetent hosts but more frequently affects immunocompromised patients. Typically, patients will present with painful subcutaneous nodules of the joints or soft tissues from traumatic inoculation. However, exhibiting a sporotrichoid-like pattern of these nodules is uncommon. Herein, we report a case of sporotrichoid-like distribution of cutaneous Mycobacterium chelonae in a patient with systemic lupus erythematosus on significant immunosuppressive medications. Clinicians treating immunocompromised patients should be cognizant of their propensity to develop unusual infections and atypical presentations.

Tracheobronchitis in a Patient With Crohn's Disease.

We report a 63-year-old woman who presented with 1 month of non-productive cough and non-bloody diarrhea. She was on maintenance therapy for a 15-year history of Crohn's disease. Treatment with systemic corticosteroids resulted in rapid improvement of both her diarrhea and respiratory symptoms. Our patient is unique in that she presented with tracheobronchitis during an acute flare of her Crohn's without obvious lung pathology on chest imaging. Tracheobronchitis is a rare manifestation of inflammatory bowel disease that should be considered in Crohn's disease patients presenting with persistent non-infectious cough.