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A 52-year-old woman diagnosed with Marfan syndrome had undergone surgeries for the correction of the aorta; Bentall procedure (32 years ago) and a thoracoabdominal aortic replacement (3 years ago). The patient was referred to the hospital with a history of prolonged fever (>40 days). On

In July 2020, a 72-year-old Japanese woman with hypertension and dyslipidaemia presented with a 5-day history of fatigue and anorexia, followed by fever, slurred speech and involuntary movement of the upper limbs. She had not travelled abroad recently. She lived at the edge of a copse located in

A 72-year-old man with a background of alcoholic hepatitis (Child-Pugh A) was transferred to our services after suffering from a prolonged fever, originally presenting a few days previously with vomiting and diarrhoea suggestive of gastroenteritis. Although his initial symptoms resolved

A 78-year-old previously healthy woman on no medical treatment suffered from bilateral leg oedema lasting more than 6 months. Although the patient had undergone close investigations at two other medical institutions, an exact reason was uncertain. She was prescribed loop diuretics under a

A 42-year-old woman presented to our hospital with a 2-month history of bilateral decreased and blurry vision accompanying mild photophobia. She had had several episodes of unsafe sex and was diagnosed with secondary syphilis 10 months prior. Despite the diagnosis, she did not undergo any treatment for the infection. An ophthalmological examination revealed bilateral macular oedema, suggesting the development of uveitis (figure 1A,B). Laboratory data for complete blood counts and chemistry were unremarkable, but there were elevations of rapid plasma reagin (RPR) test and Treponema pallidum haemagglutination test (TPHA) titres, at 1:32 and 1:5120, respectively, leading to the diagnosis of ocular syphilis. Screening tests for hepatitis B virus, hepatitis C virus and HIV yielded negative findings. …