The clinical features of severe acute respiratory syndrome-coronavirus disease 2019 (SARS-COVID-19) infection range from mild upper respiratory symptoms to severe acute respiratory failure. Among other less common features are diarrhea, nausea, vomiting, elevated liver enzymes, and acute kidney injury. We present a case of a 49-year-old female with no preexisting liver disease who presented with weakness and dizziness for one week. Initial investigations revealed acute liver failure (ALF) and positive COVID-19 on polymerase chain reaction (PCR) testing. The patient did not have any upper or lower respiratory symptoms, and extensive workup to look for other etiologies of acute liver failure was unremarkable. She eventually deteriorated to decompensated liver failure and was transitioned to comfort measures only. Liver injury is a well-documented phenomenon associated with COVID-19 infection. Some of the common pathophysiological mechanisms include direct liver injury, immune-mediated liver damage due to the severe inflammatory response, ischemic injury, endothelial disruption, and coagulopathy. Our case uniquely highlights that SARS-COVID-19 infection may have the potential to solely affect hepatocytes without the classic severe acute respiratory distress syndrome. This case demonstrates that a diagnosis of COVID-19 may be considered if no other etiology of ALF is identified.

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Fusobacterium, a gram-negative non-spore-forming anaerobe, is a common inhabitant of the oral cavity; however, it is not typically found in other organ systems. The occurrence of a hepatic abscess associated with this organism is rare. We present a patient with recurrent diverticulitis with left upper quadrant abdominal pain, and abdominal imaging revealed a hepatic abscess in addition to sigmoid diverticulitis. Further investigations led to an unusual culprit; Fusobacterium nucleatum.

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The overuse of antibiotics can lead to resistance among pathogenic bacteria. A new antibiotic that is effective against new and resistant bacterial strains is needed. Plants and marine organisms may offer such novel treatments. In this study, extracts of the seaweed U. lactuca, and the plant seeds N. sativa were tested against strains of Gram-positive cocci and Gram-negative bacilli S. aureus, and P. aeruginosa. The results of the bacterial inhibitor showed high activity in both extracts with inhibition of S. aureus growth up to 30 mm and 20 mm and P. aeruginosa growth inhibition was up to 12 mm and 15 mm, after the treated with 100 μl U. lactuca and N. sativa extracts, respectively. The MICs and MBCs were reflected with the growth inhibitor with values of 2 μl, 8 μl and 4 μl, 8 μl for S. aureus and P. aeruginosa after treated with N. sativa respectively. Kill-time increases as concentrations of U. lactuca and N. sativa extracts increase. Moreover, extracts stored in the transparent bottle decreased in effectiveness after one month of storage with percentage of 58.85%. After three months, heating the extracts of U. lactuca and N. sativa to 90˚C increased their antibacterial activity.