Highlights Exotic tropical infection in migrant populations. Intriguing history. Enigmatic taxonomy. Challenging management.

The identification of Candida auris fungemia in critically ill COVID‐19 patients is detrimental, with huge implications on patient mortality and infectious control measures.

With the evolving COVID-19 pandemic, increasing concerns about invasive fungal infections have been reported particularly with the use of potent immunosuppressant medications to treat the immunological storms in patients with severe COVID-19 illnesses. Trichosporon asahii (T. asahii) is an emerging highly resistant pathogen with considerable mortality particularly in critically ill patients and immunocompromised individuals. We describe a case of a 58-year-old patient who developed T. asahii fungemia after using immunosuppressant agents for his severe COVID-19 related cytokines release syndrome. Pseudohyphae, arthroconidia, and lateral blastoconidia were seen in the stain, and later confirmed to be T. asahii. Voriconazole successfully treated this multi-drug-resistant fungal infection. The clinical presentation, assessment, and management are reviewed to raise awareness of the circumstances leading to coinfection with this emerging resistant yeast.

Antemortem diagnosis of rabies is challenging, and usually, more than one test modality is needed to confirm the diagnosis. No effective treatment exists so far, and the Milwaukee Protocol is debatable.

Staphylococcus saprophyticus is a gram-positive, novobiocinresistant, coagulase-negative staphylococcus species. 1 It is the second most frequent causative microorganism in acute uncomplicated urinary tract infections in young, sexually active women. 2 However, it can present with a variety of complicated genitourinary tract infections which include prostatitis, pyelonephritis, and epididymitis. 3 Staphylococcus saprophyticus bacteremia rarely complicates the involvement of the urinary tract, particularly in immunocompetent hosts. 4 The clinical presentation and diagnosis are usually undistinguished S. saprophyticus bacteremia secondary to pyelonephritis from typical uropathogens. 5 Typically, S. saprophyticus is sensitive to most antimicrobials used to treat UTIs. However, there is rising resistance of S. saprophyticus to empirically and commonly used antibiotics to treat cystitis, hence, rendering the management more challenging. 6 Herein, we report an unusual highly resistant case of S. saprophyticus pyelonephritis leading to bacteremia in an otherwise healthy young female patient who was successfully treated with a course of vancomycin and daptomycin. In addition, we reviewed the literature for similar cases.