Melioidosis and leptospirosis are common tropical infectious diseases, but confirmed co-infection by both is rare. We describe a fulminant case of Burkholderia pseudomallei and Leptospira co-infection in a 29-year-old Malay lady with underlying uncontrolled type 2 diabetes mellitus, who had no obvious exposure to either organism. Despite close monitoring and aggressive treatment in the Intensive Care Unit (ICU), this patient eventually succumbed to death from the disease progression. As co-infections of melioidosis and leptospirosis can lead to a high mortality, suspicion of the diagnosis must always be raised especially in diabetic patients from endemic area, who present with sepsis of unknown origin, to allow for prompt initiation of appropriate treatment.

Dengue is a public health concern with an economic burden that is currently unmet by approved vaccinations, particular treatment medicines, or effective vector-control methods. It can be challenging to identify in an early stage, and if not treated properly, it can have disastrous effects. We, therefore, present a case of an unfortunate man diagnosed with severe dengue. He eventually had a multiorgan failure and required renal replacement therapy and inotropic support. We emphasize early recognition and investigation of dengue fever to prevent such serious complications later. We also discuss the clinical condition with radiological intervention such as assessing gallbladder wall thickness as a tool when in doubt of a diagnosis of severe dengue infection.

Since the coronavirus disease 2019 (COVID-19) pandemic emerged in November 2019, various international guidelines and local protocols have been published to assist clinicians face the pandemic effectively. Medical and ventilatory strategies have evolved and researchers have come out with multiple studies and solutions within a short period of time. The patient's best interest is always the goal of the management. We present a case report of COVID-19 pneumonia in a patient with underlying Eisenmenger syndrome and the potential benefits of high-flow nasal oxygen therapy in this patient.