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The clinical association between Coxsackievirus B (CVB) and methicillin-sensitive Staphylococcus aureus (MSSA) has not been well established in the current literature. Here, we report a case of a 29-year-old male who presented with fever and malaise 24 hours after noticing a pruritic lesion on the anterior foreleg that resembled a mosquito bite. After multiple ED visits, laboratory studies, and imaging tests, the patient was admitted for treatment of high fevers and pancytopenia. The final diagnosis was viral sepsis complicated by co-infection with MSSA., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ethridge et al.)

Lyme disease (LD) is the most common tick-borne illness across the United States, caused by the bacterium Borrelia burgdorferi sensu lato and transmitted to humans by the bite of infected Ixodes ticks. Jamestown Canyon Virus (JCV) is an emerging mosquito-borne pathogen found mostly in the upper Midwest and Northeastern United States. Co-infection between these two pathogens has not been previously reported since it would require the host to be bitten by the two infected vectors at the same time. We report a 36-year-old man who presented with erythema migrans and meningitis. While erythema migrans is a pathognomonic sign of early localized Lyme disease, Lyme meningitis does not occur in this stage but in the early disseminated stage. Furthermore, CSF tests were not supportive of neuroborreliosis, and the patient was ultimately diagnosed with JCV meningitis. We review JCV infection, LD, and this first reported co-infection to illustrate the complex interaction between different vectors and pathogens and to emphasize the importance of considering co-infection in people who live in vector-endemic areas., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Weiler et al.)

We report on a 66-year-old male who presented for evaluation of rapidly expanding lesions on his lower extremities. He first noticed these lesions following a trip to Costa Rica, in which he was bitten by several unidentified bugs. He was initially treated empirically with antibiotics in the outpatient setting with no improvement of his symptoms. His lesions continued to expand and spread locally which prompted further workup with a biopsy of one of his lesions. He was ultimately found to have Leishmaniasis (Viannis) guyanensis confirmed by microscopy and polymerase chain reaction. He was treated with aggressive wound care and amphotericin B due to the risk of progressing to involve his mucosa., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Motie et al.)