This Halloween-themed conference opened with a severe sepsis case marked by altered mental status, hypoxemia, leukocytosis, thrombocytopenia, DIC, skin findings, and an initially confusing blood culture result that was ultimately confirmed as Yersinia pestis. The case served as a springboard to review plague epidemiology, rodent and flea ecology, transmission routes, clinical syndromes, diagnostic clues, and treatment options.
The second case focused on Elsberg syndrome, or HSV-associated lumbosacral myeloradiculitis, presenting as a rare infectious cause of cauda equina-like symptoms. The teaching portion emphasized that Elsberg syndrome may have nonspecific or even negative MRI findings, is often associated with lymphocytic CSF pleocytosis, and is most classically linked to HSV-2, though other neurotropic viruses have been reported.