Background: Gut microbiota is well-known for its ability to maintain intestinal homeostasis. However, the disruption of this homeostasis, known as dysbiosis, leads to multiple consequences, including local and systemic inflammation. Surgery-induced inflammation is a major concern for patients, as it leads to many infectious and non-infectious complications. Objective: The purpose of this review was to explore the role of probiotics and symbiotics in surgery-induced inflammation and to determine if their use is effective in combatting inflammation and its complications Methods and Materials: A literature search was conducted, and articles published only in English, until December 2022 were included. The results are reported in the form of a narrative review. Results: The perioperative use of probiotics and/or symbiotics results in lower risk of infectious complications, including reduced rates of surgical site infections, respiratory and urinary tract infections, shorter hospital stays, and fewer days of antibiotic administration. It also contributes to reducing non-infectious complications, as it mitigates systemic and local inflammation via maintenance of the intestinal barrier, improves intestinal mobility, and is associated with lower rates of postoperative pain and anastomotic leak. Conclusions: Restoring gut microbiota after disruptions caused by surgery may accelerate local healing processes, attenuate systemic inflammation, and may thus prove beneficial to certain populations.

Skin and soft tissue infections caused by non-tuberculous mycobacteria are occurring more frequently in recent years. However, chronic skin and soft tissue lesions present a challenge for clinicians, as the diagnostic work-up and definitive diagnosis require knowledge and available laboratory resources. We present here the case of a 66-year-old male patient who presented with painful abscess-like nodules on his right hand and forearm, which worsened after treatment with an anti-TNF-a agent. The fluid specimen taken from the lesion was positive for mycobacteria according to the acid-fast stain. Mycobacterium marinum was identified, first by next-generation sequencing and finally grown on culture, after eight weeks. Acknowledging the complexity of diagnosing and managing infections by non-tuberculous mycobacteria, and especially Mycobacterium marinum, we provide a review of the current epidemiology, clinical characteristics, diagnosis and management of Mycobacterium marinum infection.

Background/Objectives: Fungal endocarditis (FE), is a rare yet life-threatening disease, which predominantly affects immunocompromised individuals, prosthetic valve recipients, and injection drug users. The purpose of this review is to summarize the evolving epidemiological trends, diagnostic challenges, and treatment strategies, by identifying evidence that supports the optimal clinical approach. Methods: A literature search was performed, drawing from sources such as PubMed and Google Scholar and included articles published between January 2015 and March 2025. Clinical studies, case series, and meta-analyses reporting on FE epidemiology, diagnostics, or treatment were included. Results: The majority of FE cases is caused by Candida species, predominantly C. albicans, while Aspergillus accounted for a lesser percentage of cases. While blood cultures showed limited sensitivity, adjunctive diagnostic tools such as serum biomarkers (β-D-glucan, galactomannan) and advanced imaging modalities (18F-FDG PET/CT) are increasingly used to guide the diagnostic process. Early surgical intervention combined with antifungals improved survival, particularly for Aspergillus, although comprehensive data regarding this approach remains limited due to the rarity of the disease. Conclusions: Fungal endocarditis requires an aggressive treatment strategy, integrating early surgery, targeted antifungals, and long-term suppression, especially for prosthetic valves. Despite advances, the complexity of the condition and the variety of the pathogens involved, continue to impede progress towards effective management of FE. Future research must prioritize rapid diagnostics, standardized treatment protocols, and novel antifungals to address this critical condition.

Toxocariasis is a parasitic zoonosis caused by ascarid nematodes of dogs (Toxocara canis) or cats (Toxocara cati). Transmission to humans can occur in various ways, most commonly through the ingestion of infective embryonated eggs in soil or on vegetables or fruits and less frequently through ingestion of raw or undercooked meat contaminated with larvae. The disease manifestations span a broad clinical spectrum, ranging from asymptomatic seropositivity to severe systemic complications including sepsis and septic shock, with the presentation varying according to the affected organ systems. Cardiac involvement is a rare but potentially life-threatening complication and consists of myocarditis, pericarditis or Loeffler’s endocarditis (eosinophilic myocarditis). We present a case of eosinophilic myocarditis associated with Toxocara canis infection in a 54-year-old woman living in a rural area near the forest and provide a brief review of the literature.

Background and Clinical Significance: Acquired angioedema (AAE) is a rare and potentially life-threatening condition characterized by acquired deficiency of C1-inhibitor (C1-INH) resulting in hyperactivation of the classical complement pathway. AAE occurs in association with malignancies or autoimmune diseases. Infectious triggers are rarely encountered, and the underlying mechanisms have yet to be completely clarified. Case Presentation: This case involves a previously healthy 19-year-old male who was admitted with Mycoplasma pneumonia and oral ulcers, subsequently developing unilateral facial angioedema. Laboratory studies demonstrated reduced C4, decreased levels and activity of C1-INH, and reduced C1q, all consistent with acquired C1-INH deficiency. These findings were attributed to the presence of cold agglutinins, which are frequently observed in Mycoplasma pneumoniae infections. Following treatment with icatibant, a bradykinin B2 receptor antagonist, the patient’s angioedema resolved rapidly. An exhaustive workup found no evidence of underlying systemic disorders, and the patient did not experience any angioedema attacks following resolution of the infection. Conclusions: The presence of cold agglutinins, commonly associated with Mycoplasma infections, can precipitate a decline in C1-INH levels, resulting in complement pathway dysregulation. This disruption leads to an excess of bradykinin, followed by increased vascular permeability and localized edema.

Background: Mucormycosis is an aggressive, angioinvasive mold infection that progresses rapidly and carries high mortality. Disease in non-classical hosts is readily mistaken for bacterial superinfection or the expected course of the underlying condition and the resulting delay in tissue biopsy and antifungal therapy may adversely affect outcome. Methods: We report a retrospective case series at a tertiary referral center in northern Greece over a seven-year period. Results: Nine patients (median age: 49 years, of whom 7 were male and 2 were female) with histopathologically confirmed mucormycosis were reviewed. Two previously healthy adolescents developed post-traumatic cutaneous disease and survived. Three patients reached craniofacial disease through the classic immunosuppressed route, one through poorly controlled type 1 diabetes, one through poorly controlled type 2 diabetes, and one through allogeneic transplantation for acute lymphoblastic leukemia (ALL). The remaining four developed infection on a background of barrier disruption or critical illness: two with major thermal burns (39% and 54% total body surface area), one with a cannulation-site eschar during high-dose corticosteroid therapy for dermatomyositis, and one intubated patient with prediabetes who developed forearm necrosis with local thrombosis. Rhizopus arrhizus predominated in the craniofacial and healthcare-associated cases, whereas the trauma and burn cases yielded a wider range of species. Liposomal amphotericin B (L-AmB) was the first-line agent in eight patients and one case with limited disease received isavuconazole monotherapy. Eight patients underwent surgery, ranging from debridement to orbital exenteration, maxillectomy, and in one case forequarter amputation. Eight of nine patients (89%) required admission to the Intensive Care Unit (ICU); among them, the median ICU stay was 37 days (IQR 7-57; range 2-123). Overall mortality was 67% (6/9). Conclusions: This series includes established metabolic and transplant-associated mucormycosis as well as trauma, burn, and healthcare-associated presentations. Only two patients had no documented systemic predisposition other than traumatic tissue disruption. While this small, heterogeneous patient sample cannot determine incidence, prognostic factors, or treatment effects, it may illustrate that this disease has the potential to affect patients beyond the classic host. Rapidly progressive necrosis or thrombosis should nevertheless prompt consideration of mucormycosis and tissue sampling for histopathology and culture.