• A Candida co-infection can be either primary- or secondarily acquired, i.e., presented together with or following the onset of COVID-19 disease (super-infection). • Immunosuppressants, such as corticosteroids and anti-IL-6 agents, predispose to fungal overgrowth and translocation from the gastrointestinal tract to the bloodstream. • Critically ill COVID-19 patients often presented altered fecal mycobiomes, enriched with members of the genus Candida. • Candida spp. from blood followed Gram-negative and Gram-positive bacteria as the most common nosocomial isolates in patients already infected with COVID-19. • It has been reported that hospital-onset candidemia rate significantly increased during the COVID-19 pandemic, however incidence varied significantly between studies. • C. albicans led the isolates in COVID-19 and invasive Candida co-infection in several reports, while the reported incidence of C. parapsilosis and C.auris increased during the pandemic. • The knowledge of Candida spp. local epidemiology, concerning resistance to antifungal agents, remains crucial for the selection of the empirical antifungal treatment. • During the COVID-19 pandemic, an increase in the frequency of resistance to fluconazole have been reported. • The first-line treatment consists of intravenous administration of fluconazole (unless there is local-resistance to fluconazole or suspicion for C. auris) or an echinocandin. • C. auris is a troublesome pathogen as it can persist in the hospital environment and has modes of transmission like multidrug resistant bacteria. The treatment of C. auris is challenging, as it may present resistance to several (or even all) major antifungal classes, i.e., polyenes, azoles, and echinocandins. • Invasive Candida on critically ill patients with COVID-19, increasing morbidity and mortality. Proper awareness and prevention efforts might decrease their incidence and improve their prognosis.

Schwannomas of the head and neck are relatively rare benign tumors that derive from the Schwann cells. Schwannomas are usually asymptomatic; however, tumors of bigger size may produce unspecific symptoms due to compression of the adjacent anatomic structures. Vagus nerve schwannomas may present as solitary neck masses, produce hoarseness of voice, or induce paroxysmal cough on palpation, which is also pathognomonic. Preoperative diagnosis is challenging and imaging studies may play a vital role in the diagnosis. Surgical treatment with complete tumor removal is the treatment of choice. In this study, we present a case of vagus nerve schwannoma in an adult male patient.

Inflammatory diseases of the pancreas or pancreatic trauma result in ductal cell disruption, which in turn may lead to leakage of pancreatic fluid, mostly in the retroperitoneal space. Pancreatopleural fistulas are uncommonly encountered following pancreatic injury; however, they often prove a difficult problem to manage. Herein, we present a rare case of a 68-year-old male suffering from a pancreaticopleural fistula (PF) between the pancreatic tail and the left pleural space one year following splenectomy for trauma. About three months after percutaneous drainage of a left pleural effusion and left upper quadrant abdominal collection and endoscopic pancreatic duct stent placement, surgical management was decided. Distal pancreatectomy and Roux-en-Y drainage of the pancreatic remnant were successfully performed.

Marie-Thérèse Maréchal, Nikolaos Koliakos, Dimitrios Papaconstantinou, Luca Pau, Nicolas Boyer, Mathilde Poras, Georgios Katsanos, Eleonora Farinella. Journal of Minimally Invasive Surgery 2024;27:181-3. https://doi.org/10.7602/jmis.2024.27.3.181