Aspergillus co-infection in patients with severe coronavirus disease 2019 (COVID-19) pneumonia, leading to acute respiratory distress syndrome, has recently been reported. To date, 38 cases have been reported, with other cases most likely undiagnosed mainly due to a lack of clinical awareness and diagnostic screening. Importantly, there is currently no agreed case definition of COVID-19 associated invasive pulmonary aspergillosis (CAPA) that could aid in the early detection of this co-infection. Additionally, with the global emergence of triazole resistance, we emphasize the importance of antifungal susceptibility testing in order to ensure appropriate antifungal therapy. Herein is a review of 38 published CAPA cases, which highlights the diagnostic and therapeutic challenges posed by this novel fungal co-infection.

We describe a multidrug-resistant Neisseria gonorrhoeae urethritis case with ceftriaxone resistance and azithromycin intermediate resistance in a heterosexual man in Ireland, August 2018. Whole-genome sequencing showed that the isolate IR72 belongs to the internationally spreading multidrug-resistant ceftriaxone-resistant FC428 clade, initially described in Japan in 2015. IR72 was assigned MSLT ST1903, NG-MAST ST17842 and NG-STAR type 1133, including the ceftriaxone resistance-mediating penA-60.001. Global awareness of spreading ceftriaxone-resistant gonococcal strains that threaten recommended dual therapies is essential.

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Granulomatous mastitis is a rare breast disease that classically occurs in parous women of reproductive age. In recent years, an association has been reported between this condition and Corynebacterium species, which are gram-positive bacilli that are endogenous to the skin. We describe a case of granulomatous mastitis associated with Corynebacterium kroppenstedtii, a lipophilic organism with an affinity for the lipid-rich mammary glands. We highlight the need to consider this pathogen to guide investigation and describe the diagnostic challenges related to isolation and identification of the organism. In addition, we report on successful treatment of the patient with a prolonged course of a combination of clarithromycin and rifampin.