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Heparin, one of the world’s oldest anticoagulation medications, accelerates the rate ofinhibition of previously activated clotting factors. It is most often used in the prophylaxis andtreatment of thromboembolic disorders and complications associated with atrial fibrillation.The two most common ways to monitor plasma heparin levels and anticoagulation therapyare the activated partial thromboplastin time (aPTT) and anti-factor Xa assay (anti-Xa). Thisarticle assesses the performance of aPTT and anti-Xa monitoring protocols and analyzes thediscordance between aPTT and anti-Xa levels and its clinical implications in patients receivingintravenous heparin therapy.

Cerebral phaeohyphomycosis is infection of the central nervous system (CNS) caused by dematiaceous fungi. The most common mechanisms of infection are by direct extension from the paranasal sinuses or by hematogenous spread. The mortality rate is high and ranges from 50%–79% in the limited studies on this infection. Our case describes a young man without any preexisting disease who acquired cerebral phaeohyphomycosis following nasal inhalation of garden mushrooms. Despite aggressive treatment, he ultimately died due to this severe infection. Our case report discusses our treatment approach and reviews the literature on this deadly infection. Keywords: fungal infection, cerebral abscess, Bipolaris, phaeohyphomycosis