Sporothrix schenckii grew from cultures!
Treatment: itraconazole
Joints improved but eye had to be excised.

#ESCMIDGlobal2026

Dr Khanna mentions testing for HIV in setting of lymphopenia, and looking to consider symptoms as manifestation of opportunistic infection.
Fungi such as histo, cocci, sporothrix are also considered by the panel
Dr Slavin adds possibility of IE

#ESCMIDGlobal2026

Labs show lymphopenia and ESR 31
Large cystic lesion near knee and septic arthritis with abscesses in hand and foot.
Knee aspiration had neutrophil predominance.

Dr Kontoyiannis considering brucella suis.
#ESCMIDGlobal2026

Next up: Dr Lauren Saint from UNC discusses a case of joint swelling in knee, finger, toe. Skin lesions and painful eye with blurry vision and increased eye pressure and uveitis leading to loss of vision in eye. US travel only. Transports live pigs as truck driver.

Very wide differential offered by experts.

Schistosomiasis was first thing mentioned by David Paterson!

discussing CNS TB; CSF PCR was negative but not sufficient.

3 further schistosomiasis tests positive

Treatment: ivermectin (for strongy), praziquantel, Dex
Patient improved
#ESCMIDGlobal2026

Next case in clinical grand rounds is quant-positive patient from London with oral ulcers, thalamic lesion, CSF pleiocytosis, eosinophilia, and travel history

#ESCMIDGlobal2026

My first session on the last day of #ESCMIDGlobal2026 is Bird flu is no longer just for birds: from strategic planning to public health readiness. The first speaker is Ben Cowling with What drives pandemic risk? Virus, population and policy influencing influenza H1N1 spread

As always, Clinical Grand Rounds led expertly by Dr Robert Read, delivers
Great case of secondary syphilis with disseminated spirochetes seen in various tissues

#ESCMIDGlobal2026

Waldorf and Statler enjoying the “trial run to non-inferiority” session at ESCMID Global 2026, remembering the times of superiority.

@cmicomms.bsky.social @angelahuttner.bsky.social @absteward.bsky.social

“This Year in Public Health” at #ESCMIDGlobal2026:

💉 Vaccines can stop cholera—but timing is everything
⏳ Doses arriving 2–4 weeks late = outbreaks already accelerating
🚑 8M vaccines delivered, massive mobilization on the ground

We have the tools. The gap is speed, access, and delivery.

“This Year in Public Health” at #ESCMIDGlobal2026:

⚔️ War accelerates AMR
🏥 Strained systems + disrupted surveillance
🦠 Resistance spreads across care networks

A hidden consequence of conflict—and a growing threat.

“This Year in Public Health” at #ESCMIDGlobal2026:

💊 Cutting unnecessary antibiotics isn’t just good medicine—it saves money
📉 Stewardship programs reduce overprescribing
💰 Lower drug costs, fewer adverse events, less AMR burden

Better prescribing = better outcomes + real savings

Dr Hanevik selected this paper to discuss impact of Russian invasion in Ukraine on AMR. Large increase reported in this - and many other - papers

#ESCMIDGlobal2026

journals.lww.com/jtrauma/full...

Multistate cholera outbreak in Sudan amid ongoing armed conflict, 2023-2024 In 2023, Sudan experienced a major cholera outbreak affecting 10 states amidst armed conflict that severely disrupted health services.This study aimed…

Also mentions this report on cholera in Sudan. War and conflict inevitably leads to public health disasters unsurprisingly.

#ESCMIDGlobal2026

www.sciencedirect.com/science/arti...

Geographical shifting of cholera burden in Africa and its implications for disease control - Nature Medicine High-resolution geospatial mapping found that the annual incidence of cholera shifted from western to central and eastern Africa between 2011 and 2020, with the latter regions more likely to report ch...

Now emphasizing the ongoing threat of cholera. Important, preventable cause of mortality.

#ESCMIDGlobal2026

www.nature.com/articles/s41...

My first #ESCMIDGlobal2026 session on Monday is Interconnected microbiomes and resistomes across One Health. The first speaker is Amy Mathers with Hospital microbiomes as hotspots for emerging resistance: surveillance-to-intervention

“This Year in Public Health” at #ESCMIDGlobal2026:

📊 Global DALYs tell the story across the lifespan
👶 Early life still shaped by infectious diseases
🧓 Later life dominated by NCDs (CV disease, cancer, neuro)
⚠️ Injuries and mental health contribute across ages

The burden is shifting

Of course, as also highlighted by Dr Kontoyiannis yesterday, infectious diseases remain a major threat for patients with cancer.

#ESCMIDGlobal2026

Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990–2023: a system... Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural ri...

Dr Kurt Hanevik starts his overview of year in public health with a Lancet report on global burden of disease. Communicable diseases dominate in early years with other causes such as cancer more important in older people.

#ESCMIDGlobal2026

www.thelancet.com/journals/lan...

Normal urine is not sterile!
Urine microbiome being introduced by @nicoledenisco.bsky.social
#ESCMIDGlobal2026 #UTISky

A natural experiment on the effect of herpes zoster vaccination on dementia - Nature Using a natural experiment that avoids common bias concerns, this study finds that the live-attenuated shingles vaccine reduced the probability of a new dementia diagnosis within a follow-up period of...

Dr Fisman highlights many advantages of vaccination that even go beyond direct impact on ID prevention such as benefits of flu vaccination on MI risk and zoster vaccination on dementia risk (example of latter below)

#ESCMIDGlobal2026

www.nature.com/articles/s41...

Modeling Reemergence of Vaccine-Eliminated Infectious Diseases Under Declining Vaccination in the US This study estimates the number of cases and complications in the US under scenarios of declining childhood vaccination for measles, rubella, poliomyelitis, and diphtheria.

Dr. Fisman now moves to “worst of times” in public health and discusses this paper on lower vaccine rates and expected re-emergence of various diseases including measles.
#ESCMIDGlobal2026

jamanetwork.com/journals/jam...

Effectiveness of the RTS,S/AS01E malaria vaccine in a real-world setting over 1 year of follow-up after the three-dose primary schedule: an interim analysis of a phase 4 study in Ghana, Kenya, and Mal... Over 1 year of follow-up after the third vaccine dose, vaccination with RTS,S/AS01E in real-world settings showed significant reductions in malaria burden. These findings reinforce the continued use o...

Another success story highlighted by Dr Fisman is a description of malaria vaccination resulting in 17% reduction in mortality.

#ESCMIDGlobal2026

www.thelancet.com/journals/lan...

Dr. Fisman highlights Marburg response as public health success story.
Enhanced resources limited spread of Marburg virus in Ethiopia.

#ESCMIDGlobal2026

pubmed.ncbi.nlm.nih.gov/41906712/

Global perspectives on infectious diseases at risk of escalation and their drivers - Scientific Reports Scientific Reports - Global perspectives on infectious diseases at risk of escalation and their drivers

First paper discussed deals with the current ID threat environment with TB, malaria, bacterial AMR, and respiratory viruses ranking highest, and geographical variation noted in priorization
#ESCMIDGlobal2026

www.nature.com/articles/s41...

Dr. David Fisman kicks it off with “it was the best of times, it was the worst of times”
Best: development in new tools in genomics and vaccinology. Worst: global disruption of public health infrastructure.

#ESCMIDGlobal2026

A year in public health about to start in ICM14. Should be a good one ⭐️

#ESCMIDGlobal2026

Dr. Kontoyiannis: 58% of leukemia treatments in development have interactions with azole antifungals and of course many currently approved agents have similar concerns.

This is already resulting in many patients on second line prophylaxis

#ESCMIDGlobal2026

Definitely

JAMA Research Summary: Fast Antimicrobial Susceptibility Testing. Key findings: Rapid AST had a 48.8% desirable outcome, not superior to standard. No difference in mortality. Trial involved 850 patients in Greece, India, Israel, Spain.

Presented at #ESCMIDGlobal2026:

📊 Research Summary: In patients with #GramNegativeBacteremia, rapid #AntimicrobialSusceptibilityTesting did not improve 30-day outcomes compared with standard testing, although it supported faster antibiotic adjustments.

ja.ma/4cpmioY