Leptospirosis is a zoonotic spirochaetal infection with a broad clinical spectrum, ranging from mild anicteric illness to severe systemic disease. Central nervous system (CNS) involvement, particularly aseptic meningitis, is an underrecognized and diagnostically challenging manifestation, especially when isolated from systemic signs. We report a case of a 43-year-old male with a history of CNS demyelinating disease, treated with rituximab, who presented with a one-month history of recurrent fever, headache, and painful lower extremity nodules. He also experienced unintentional weight loss. After a thorough infectious workup, cerebrospinal fluid (CSF) analysis, including broad-range PCR and the Karius test, confirmed the diagnosis of leptospirosis caused by Leptospira noguchii. He was initially treated with intravenous ceftriaxone and oral doxycycline for 7 days, resulting in symptomatic improvement. However, symptoms recurred two weeks later, with repeat CSF analysis revealing persistent pleocytosis, necessitating a prolonged course of treatment. This case underscores the limitations of conventional testing in immunocompromised hosts and highlights the critical role of advanced molecular diagnostics for early and accurate detection of neuroleptospirosis. Clinicians should maintain high suspicion for leptospiral meningitis in appropriate clinical contexts to improve outcomes through timely intervention.

Potassium is vital for cellular function, particularly in excitable tissues like nerves and muscles, which rely on potassium gradients to function normally. Hypokalemia can lead to severe issues such as muscle weakness and irregular heart rhythms. This case series presents four instances of hypokalemic paralysis, a neuromuscular condition that can be either periodic or isolated. The cases vary in presentation and treatment approach, highlighting the need to differentiate between primary and secondary causes of hypokalemia for optimal management. Fast and accurate diagnosis through laboratory tests and history taking is critical, and while acute management is standard, preventive strategies depend on the underlying cause. Further research is needed to establish definitive guidelines for the prevention of hypokalemic paralysis.

Candida krusei empyema is a rare but serious manifestation of invasive candidiasis, characterized by intrinsic resistance to fluconazole, biofilm formation, and high mortality, with limited case-level data to inform management. This review aims to systematically identify and synthesize all reported English-language cases of Candida krusei empyema from January 2005 to June 2025 using PubMed, ScienceDirect, OVID MEDLINE, and Gale OneFile and perform descriptive analysis on them. Screening, data extraction, and eligibility assessment were performed, and those articles not clearly meeting eligibility criteria were reviewed by additional reviewers with consensus resolution. Seven publications (six individual cases and two cohorts) were included. We additionally describe the clinical course, management, and outcome of a 70-year-old bilateral lung transplant patient who developed persistent C. krusei empyema despite optimized antifungal therapy. Patients ranged from 11 to 74 years of age (median 62.5 years). Predisposing factors included esophageal perforation (n = 4), post-transplant hemorrhage (n = 1), community-acquired empyema (n = 1), and thoracic surgery (n = 1). Empiric fluconazole was switched to caspofungin (3/4), with others receiving amphotericin B, voriconazole, or combination therapy. Source control varied: chest tube drainage (n = 3), percutaneous catheter (n = 3), and surgical decortication (n = 2). Mortality was 14.3% (1/7). In the absence of clear guidelines and robust literature, the management approach remains heterogeneous. Optimal care requires early recognition, aggressive multimodal antifungal therapy, and effective source control tailored to patient risk. Standardized antifungal protocols and larger case series are needed to guide clinicians in managing this challenging infection.

Cervicofacial actinomycosis is a well-recognized infectious disease caused by Actinomyces, a Gram-positive filamentous bacterium. In contrast, Nocardia, a morphologically similar, hyphae-forming organism, is an exceedingly rare cause of cervicofacial abscesses, and even more uncommon associated osteomyelitis of mandible. We present such a case involving a kidney transplant recipient who presented with opioid-induced constipation, along with left jaw pain and swelling. CT scan of the soft tissue in the neck revealed a complex cervicofacial abscess with enhancement of underlying mandible. Culture growth and RNA sequencing of USG-guided aspirate identified a Nocardia species closely related to N. beijingensis/exalbida. The patient initially received broad-spectrum antibiotics, including ceftriaxone, imipenem, and trimethoprim-sulfamethoxazole (TMP-SMX). Imipenem was later discontinued in view of new-onset unexplained encephalopathy and replaced with linezolid, which was subsequently switched to minocycline following thrombocytopenia development. Minocycline therapy was intended for a total of 12 months. TMP-SMX was avoided long-term due to avoid nephrotoxicity risk in kidney transplant patients. On six-month follow-up, the patient showed clinical and radiological improvement; minocycline was discontinued after additional six months. This case highlights the importance of considering Nocardia as a differential diagnosis in immunosuppressed patients presenting with cervicofacial symptoms, especially following orofacial surgery or trauma. Early recognition, prompt diagnosis, and appropriate antibiotic therapy with adequate bone penetration seem crucial for optimal management and may help avoid the need for surgical intervention.

The publication rate of abstracts presented at a conference can provide some insight into its academic quality, although it is hardly the sole metric. We evaluated 351 SHEA Spring Conference abstracts; 49.9% were published. Findings demonstrate the strong academic output of SHEA conferences.