Several studies from the current 2022 monkeypox (MPX) outbreak have documented co-infections with sexually transmitted infections (STIs), such as gonorrhea, chlamydia, and syphilis. We present a patient with MPX and secondary syphilis who failed to clear the MPX virus 30 days after illness onset despite a 14-day course of tecovirimat therapy.

Mucormycosis (MCM) is an opportunistic fungal infection in immunocompromised hosts, most commonly associated with poorly controlled diabetes mellitus (DM). We conducted a retrospective review of 45 MCM cases diagnosed between 2010 and 2023 at a referral center in Central California, a region with high DM prevalence and significant healthcare disparities. Clinical features, histopathology, microbiology, treatment, and outcomes were analyzed. Ninety-six percent of patients had DM, and 69% had no other predisposing condition. Glycemic control was markedly poor: 36% had HbA1c > 10%, and 61% had HbA1c > 8%. Diabetic ketoacidosis (DKA) was present in 19% of patients and associated with 100% mortality. Rhino-orbito-cerebral mucormycosis (ROCM) accounted for 60% of cases and carried a 70% mortality rate. Angioinvasion, confirmed in 62% of biopsied cases, significantly increased mortality (69% vs. 28%, p = 0.015). In-hospital mortality remained high at 58%, consistent with outcomes reported in other high-burden settings. Over 60% of patients identified as Hispanic. ZIP code–based analyses revealed that 75% of individuals lived in neighborhoods with Healthy Places Index (HPI) scores below the 25th percentile, and 64% resided in areas with a Social Deprivation Index (SDI) of 85 or higher, indicating entrenched structural disadvantage. Our findings highlight that MCM in Central California disproportionately affects individuals with uncontrolled DM living in socially deprived areas. These data underscore the need for early diagnosis, targeted antifungal therapy, and upstream public health interventions addressing diabetes management and healthcare access.