IntroductionTalaromyces marneffei infection is a systemic mycosis, caused by a dimorphic fungus, an opportunistic pathogen formerly known as Penicillium marneffei. This disease is endemic to Southeast Asia and common in human immunodeficiency virus (HIV) infected patients with low CD4 counts. Here we present a very rarely reported case of Talaromyces marneffei infection in an apparent non-immunosuppressed patient presenting decades later in a non-endemic setting (United States).Presentation of caseOur patient was a 75-year-old Caucasian Navy veteran, who served in Vietnam as a part of the Swift Boat service in 1966. He presented to his primary care provider with uncontrolled nonproductive cough and abnormal chest computerized tomography. Bronchoscopy specimens showed Talaromyces. He was empirically treated with itraconazole and then switched to voriconazole after confirmation of diagnosis but he later deteriorated was changed to liposomal amphotericin B and isavuconazole. Patient did well for the next 90 days on isavuconazole until the therapy was stopped. Soon after stopping the medication (isavuconazole) his symptoms recurred and ultimately patient expired.DiscussionTalaromycosis generally presents as pulmonary infection with manifestations similar with other endemic fungi. It is often seen HIV patients with travel to South east Asia. Very rarely this infection is seen and reported in non-immunosuppressed and in non-endemic areas. To date there are 4 well-documented cases among non-HIV, non-endemic population.ConclusionTalaromyces can cause infection in non-HIV and non-endemic population and could be an underrecognized cause of pulmonary infections among veterans with even a remote history of exposure to the organism during deployment.

Aspergillus scleritis is a potentially devastating ocular infection difficult to treat because of poor scleral vascularity. Most Aspergillus cases occur following ocular surgery, but others have been associated with trauma or intravenous drug use. No anti-fungal agents are consistently efficacious in the treatment of scleral fungal infections. We report a case of Aspergillus scleritis successfully treated with a combination of voriconazole and caspofungin, as well as a review of the literature concerning treatment of Aspergillus scleritis.

We conducted an observational study of a multi-center healthcare system to determine the effectiveness of our infection control/PPE program during the care of COVID-19 patients. The COVID-19 conversion rate in the patient care setting was 0.70%. Comparatively, the conversion rate noted in the non-patient care/community setting was 15.17%.

The excavations by William Pengelly between 1865 and 1880 at Kent's Cavern, Torquay, were a well-known episode in British Quaternary bone-cave exploration. Enormous numbers of bones and artefacts were removed from the cave system during the course of these excavations, and many of the finds were lodged in the British Museum and the Torquay Natural History Society Museum. However, some material was dispersed to other UK museums, as mentioned by Tresise (1976) and Hancock et (1976). The exact basis of these dispersals seems poorly documented but Bolton acquired its material in 1903 (Acc.No. 72.03) from W.J. Else, then curator of the Torquay Natural History Society.