Background: Bacterial and fungal superinfections are commonly reported in patients with coronavirus disease 2019. Case presentation: We report the first case of brain and intramedullary abscesses caused by Pseudomonas aeruginosa and a rare case of brain abscesses caused by Aspergillus fumigatus in two post-coronavirus disease 2019 patients. The first patient—34-year-old Iranian woman—presented with weakness of the left upper limb, headaches, and lower limb paresthesia. She had a history of undiagnosed diabetes and had received corticosteroid therapy. The second patient—45-year-old Iranian man—presented with right-sided weakness and had a history of intensive care unit admission. Both patients passed away despite appropriate medical therapy. Conclusion: The immune dysregulation induced by coronavirus disease 2019 and its’ treatments can predispose patients, especially immunosuppressed ones, to bacterial and fungal infections with unusual and opportunistic pathogens in the central nervous system. Pseudomonas aeruginosa and Aspergillus fumigatus should be considered as potential causes of brain infection in any coronavirus disease 2019 patient presenting with neurological symptoms and evidence of brain abscess in imaging, regardless of sinonasal involvement. These patients should get started on appropriate antimicrobial therapy as soon as possible, as any delay in diagnosis or treatment can be associated with adverse outcomes.

OBJECTIVE: Craniofacial clefts, characterized by congenital disruptions in the development of facial and cranial tissues, often present alongside orbital hypertelorism (ORH), an abnormal increase in the interorbital distance. These conditions pose significant challenges in craniofacial surgery due to the complex anatomical and functional considerations involved. This single-center cohort study retrospectively analyzed 22 patients diagnosed with craniofacial cleft syndromes and ORH who were treated at the Craniofacial Centre, Fatima Plastic and Reconstructive Surgery Hospital between July 2016 and October 2023. METHODS: This study outlines the preoperative evaluations, surgical interventions, and postoperative outcomes of these cases. Surgical techniques varied according to the severity and type of deformity, guided by Tessier’s classification system. Procedures included spectacle osteotomy, box osteotomy, and facial bipartition osteotomy, with each approach tailored to address the unique anatomical challenges presented by ORH and associated craniofacial anomalies. RESULTS: There was a 9% incidence of postoperative infections and a 22.7% incidence of CSF leakage, with a subset of these leading to meningitis. These complications underscore the complexity of managing craniofacial clefts and ORH, highlighting the necessity for meticulous surgical planning and postoperative care. CONCLUSIONS: Despite the challenges, the study demonstrates that individualized, protocol-driven surgical interventions can achieve significant aesthetic and functional improvements in patients with these congenital anomalies.

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