Febrile neutropenia (FN) is a common but serious complication encountered in patients with cancer and is associated with significant morbidity and mortality. In this prospective study, 63 patients with solid tumors under chemotherapy or immunotherapy were admitted to the hospital due to febrile neutropenia, confirmed through clinical or microbiological documentation. The aim of this study was to provide a comprehensive overview of the epidemiological and microbiological characteristics of hospitalized neutropenic patients with solid tumors undergoing treatment. Additionally, we aimed to assess the duration of neutropenia and identify factors influencing patient outcomes. The median age of patients was 71 ± 10.2 years, most of which were males (66.7%), and the primitive tumor location was the lung (38.1%), with most patients (82.5%) being at disease stage IV. The median duration of neutropenia was three days (range 1–10), and, notably, mucositis was significantly associated with neutropenia lasting ≥3 days (p = 0.012). Patients with lung cancer (38.1%) and patients with stage IV disease (82.5%) presented a higher risk of FN, although these differences did not reach statistical significance. The site of infection was identifiable in 55.6% of patients, with positive cultures detected in 34.9% and positive blood cultures (BC) drawn in 17.5% of cases. Gram-positive bacteria were the predominant causative agents in BC (63.6%), with Staphylococci being the most prevalent among them (66.7%). The median duration of hospitalization was nine days (range, 3–43 days), and most patients showed improvement or cure of infection (16.9% and 74.6%, respectively). Among recorded risk factors, the Eastern Cooperative Oncology Group (ECOG) performance status (PS) appears to be statistically significant. Patients with an impaired PS score (2–4) experienced worse outcomes and higher likelihood of mortality (p = 0.004). Regarding the outcome, a longer duration of neutropenia was also statistically significant (p = 0.050). Of the patients, 12.7% ultimately succumbed to their conditions, with 37.5% attributed to infections. FN is a common yet serious complication in solid tumor patients. Adequate knowledge of the predictors of mortality and the microbiological causes are of utmost importance to allow accurate diagnosis and prompt treatment as they significantly influence patient outcomes.

Background. Lemierre syndrome (LS) is a rare complication of upper aerodigestive tract infections characterized by proximal and distal septic emboli, commonly including internal jugular vein (IJV) thrombosis. Diagnosis can be challenging, and treatment delays can result in increased patient morbidity and mortality. We present a rare case of LS with extensive thrombosis and multiple sites of distal infection and a narrative review of the literature. Case Presentation. A 52‐year‐old Caucasian male was transferred to the emergency department (ED) with an altered level of consciousness and clinical findings of acute bacterial pharyngotonsillitis. Medical history included cervical spine disorder and traumatic brain injury in the past, as well as the recent use of pain relievers due to acute cervical pain. Imaging studies revealed left IJV thrombosis that extended into multiple venous cerebral sinuses and infiltrates of the right lung. LS was considered the most likely diagnosis. The patient was intubated and transferred to the intensive care unit (ICU). Treatment included intravenous broad‐spectrum antibiotics and anticoagulation therapy. Response to treatment was satisfactory. After extubation, he was transferred to a ward and discharged with resolution of clinical and imaging findings. Conclusion. LS is a rare disease and may have an insidious course. Timely diagnosis and appropriate treatment strategies, mainly broad‐spectrum antibiotics, offer favorable outcomes in otherwise healthy individuals. The indications for anticoagulation therapy still remain controversial. Anticoagulants are usually administered to patients with extensive thrombosis. Surgical treatment includes abscess drainage, while IJV ligation and excision are reserved for nonresponders to medical treatment.

Kytococcus belongs to the family Kytococcaceae, in the order Micrococcales, in the class Actinomycetes, and the phylum Actinomycetota. Kytococcus are aerobic, Gram-positive, non-spore forming bacteria that form coccoid, non-motile, non-encapsulated cells, and their colonies on agar have a yellow color. Infections by these species are increasingly identified nowadays. This narrative review aimed to present all available cases of Kytococcus spp. infections in humans, emphasizing data on the epidemiology, antimicrobial resistance, antimicrobial treatment, and mortality. A narrative review based on a literature search of the PubMed/MedLine and Scopus databases was performed. Results: In total, 26 articles providing data on 30 patients with Kytococcus spp. infections were included in this analysis. The median age was 59.5 years, while 56.7% were male. The presence of a prosthetic cardiac valve was the main predisposing factor in 36.7% of patients (100% among those with infective endocarditis), while immunosuppression due to underlying hematological malignancy under chemotherapy was the second most common. Bacteremia was the most common type of infection, with infective endocarditis being the most common subtype in this infection type, while respiratory tract infections and osteoarticular infections were also relatively common. K. schroeteri was the most commonly identified species. Microbial identification required the use of advanced molecular techniques such as 16s rRNA sequencing in most cases. Kytotoccus spp. was resistant to all beta-lactams with the exception of carbapenems and macrolides. The most commonly used antimicrobials were vancomycin and rifampicin. Mortality was significant (30%). Due to the potential of Kytotoccus spp. to cause infective endocarditis in patients with prosthetic cardiac valves and respiratory tract infections with concomitant bacteremia in patients with hematological malignancy under chemotherapy along with the difficulties in pathogen identification, clinicians and laboratory personnel should consider this pathogen in the differential diagnosis in patients with typical predisposing factors and clinical presentation, especially when traditional microbiological techniques are used for pathogen identification.

Introduction: Leptospirosis is an under-recognized zoonosis that affects both tropical and temperate regions. While it is often associated with exposure to contaminated water or infected animals, its presentation and epidemiology in Mediterranean countries remain incompletely understood. This retrospective cohort study investigates the clinical and epidemiological profile of leptospirosis in Crete, Greece, a region where data are scarce. Methods: All adult patients with laboratory-confirmed leptospirosis admitted to three major public hospitals in Crete, Greece, between January 2019 and December 2023 were included in the analysis. Diagnosis was made through serologic testing along with compatible clinical symptoms. Results: A total of 17 patients were included. Their median age was 48 years, with a predominance of males (70.6%). Notably, more than half of the patients had no documented exposure to classic risk factors such as rodents or standing water. Clinical presentations were varied but commonly included fever, fatigue, acute kidney injury, and jaundice. Of the patients who underwent imaging, most showed hepatomegaly. The median delay from symptom onset to diagnosis was 11 days, underscoring the diagnostic challenge in non-endemic areas. Ceftriaxone was the most frequently administered antibiotic (76.5%), often in combination with tetracyclines or quinolones. Despite treatment, three patients (17.6%) died, all presenting with severe manifestations such as ARDS, liver failure, or shock. A concerning increase in cases was noted in 2023. Conclusions: Leptospirosis can present with severe and potentially fatal outcomes even in previously healthy individuals and in regions not traditionally considered endemic. The relatively high mortality and disease frequency noted emphasize the importance of maintaining a high index of suspicion. Timely diagnosis and appropriate antimicrobial therapy are essential to improving patient outcomes. Additionally, the need for enhanced public health awareness, diagnostic capacity, and possibly environmental surveillance to control this neglected but impactful disease better, should be emphasized.