The COVID-19 pandemic and its associated vaccine have highlighted vaccine hesitancy among healthcare workers (HCWs). Vaccine hesitancy among this group existed prior to the pandemic and particularly centered around influenza vaccination. Being a physician, having more advanced education, and previous vaccination habits are frequently associated with vaccine acceptance. The relationship between age and caring for patients on COVID-19 vaccination is unclear, with studies providing opposing results. Reasons for hesitancy include concerns about safety and efficacy, mistrust of government and institutions, waiting for more data, and feeling that personal rights are being infringed upon. Many of these reasons reflect previous attitudes about influenza vaccination as well as political beliefs and views of personal autonomy. Finally, several interventions to encourage vaccination have been studied, including education programs and non-monetary incentives with the most effective studies using a combination of methods.

Candida infection is seen in patients with weak or disrupted host responses. Cutaneous candidiasis typically affects the intertriginous areas and presents with a red plaque surrounded by satellite lesions. Diagnosis of cutaneous candidiasis is made by visual inspection followed by potassium hydroxide normal saline microscopic preparation (wet mount) and polymerase chain reaction identification or culture of fungal organism. The following case describes a 38-year-old patient with limited mobility who presented with a peri sacral lesion that was first assumed to be a decubitus ulcer by nursing facility staff, but proved to be a cutaneous infection by Candida tropicalis, a less common Candida species. The unusual location as well as the characteristic C. tropicalis micro- and macroscopic appearance are described which ultimately led to the diagnosis of a cutaneous fungal infection in an otherwise immunocompetent individual that was resolved with fluconazole therapy. Our case report emphasizes the need for early diagnosis of cutaneous lesions in patients with limited mobility in consideration that not all Candida species thrive in similar environments and can present in unusual locations of the human body. Although rare, C. tropicalis could be found in this vulnerable population.

Carotid cavernous fistula is a serious vascular pathology that is commonly misdiagnosed due to clinical signs that overlap with several other pathologies and the need for sensitive imaging techniques, most notably digital subtraction angiography, to make the diagnosis. Here we present a case of carotid cavernous fistula mimicking orbital cellulitis, ultimately diagnosed with magnetic resonance venography.