Extensive folliculitis and abscesses with a sporotrichoid distribution in a parenteral drug user.

We present the case of a 53-year-old Caucasian man with a history of intravenous drug use who presented with fever and multiple pustules predominantly affecting hairy areas of the body, with no clinical improvement despite previous antibiotic treatment. Culture of the pustules confirmed Candida albicans infection and histological examination of skin biopsies revealed suppurative granulomas compatible with candidomycetic folliculitis. The patient was successfully treated with systemic antifungals and discharged with resolution of symptoms. Candidomycetic folliculitis is a condition typically associated with brown heroin consumption due to the use of acidic solvent that promotes Candida growth. Clinical manifestations include fever followed by skin lesions, with possible systemic involvement if untreated. Extensive folliculitis with associated fever in an IVDU should raise suspicion of this pathology since early diagnosis and appropriate treatment are crucial to prevent complications.

Myocarditis in a young male affected with monkeypox infection: a case report.

Background: Concerns on monkeypox as a disease impacting global public health first emerged in May, 2022, and, since that time, has been identified in more than 50 countries. The condition mainly affects men who have sex with other men. Cardiac disease is a rare complication of monkeypox infection. Here, we describe a case of myocarditis in a young male subsequently diagnosed with monkeypox infection. Case summary: A 42-year-old male reported engaging in high-risk sexual behaviours with another male 10 days before presenting to the emergency department with chest pain, fever, maculopapular rash, and a necrotic chin lesion. Electrocardiography revealed diffuse concave ST-segment elevation associated with elevated cardiac biomarkers. Transthoracic echocardiography revealed normal biventricular systolic function without wall motion abnormalities. We excluded other sexually transmitted diseases or viral infections. Cardiac magnetic resonance imaging (MRI) findings suggested myopericarditis involving the lateral wall and adjacent pericardium. The results of polymerase chain reaction (PCR) tests of pharyngeal, urethral, and blood samples were positive for monkeypox. The patient was treated with high-dose non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine and he recovered soon. Discussion: Monkeypox infections are generally self-limited, with most patients experiencing benign clinical outcomes, no hospitalizations, and few complications. This is a rare report of monkeypox complicated with myopericarditis. Management with high-dose NSAIDs and colchicine relieved our patient's symptoms, suggesting a similar clinical outcome as other idiopathic or virus-related myopericarditis.