A three years old male was presented, fatigued with history of fever for 4 days. He became acutely ill and vomited during lunch. Over the next 4 days he developed fever as high as 40oC that was controlled by Acetaminophen. He developed cough, rhinorrhea, and conjunctivitis. His parents reported that he was very sleepy. Over the past 2 days, he had begun to rub his eyes and complained a severe pain in it His parents noted that his eyes were puffy and sensitive to light. He had had no rashes. The patient’s lips were dried and cracked and he has a greatly reduced urinary output (To be continued...).

Identification and characterization of micro-organisms that cause infections are crucial for successful management of patients. For several decades, routine clinical microbiological diagnostic laboratories have been equipped with a growing panel of culture-dependent and culture-independent methods to investigate the microbial etiology of infectious diseases. Considering the disadvantages of traditional methods, multiplex PCR techniques have been routinely endorsed in clinical microbiology laboratories as rapid and sensitive diagnostic and prognostic tool including many PCR panels routinely used in microbial diagnostics. The great advance in medical biotechnology has been associated with development of Matrix-Associated Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI TOF MS). The power of MALDI TOF MS correctly identified 93.2% of organisms to the species level and 5.3% to the genus level. Recently, the application of next-generation sequencing (NGS) technology and its various methodological variants makes it possible to detect different types of microorganisms present within a microbial sample simultaneously, using a culture-independent approach and in a single sequencing run. Over the next 5 to 10 years, although it is unlikely to see NGS completely replacing the conventional culture and susceptibility methods, a wealth of NGS applications will be acquired in the vast majority of diagnostic microbiology laboratories worldwide, providing enhanced diagnostic capabilities and improving the quality of patients care. In Egyptian diagnostic microbiology laboratories, we have to ask ourselves; are we ready to subsist this new era? Sure the answer is: ‘All things are ready, if our mind be so’.

Background: The Cuban health-care system recommends the hospital admissions of patients with unspecified febrile syndrome (UFS) to rule out arboviral diseases and to prevent healthcare associated adverse outcomes. Aim: Evaluate the burden of unspecified febrile syndrome in a Cuban hospital. Methods: A cross-sectional study was carried out in the Hospital Joaquín Albarrán (La Habana, Cuba) from 1 January 2017 to 31 December 2019. It was collected the admissions and patients days (total and UFS patients) and laboratory test for dengue diagnosis. Results: During the three-year period, the epidemic curve starts in April-May and decline in November, with the highest peak in August 2019. It was admitted 16964 patients with UFS representing 43% of the hospital admissions, and 43512 patients’ days were documented. In 2019 the 51.9% of the hospital admissions and 22.9% of patients’ days were related to UFS, and were performed 7492 IgM test (repeated test in 89 patients) and 46.2% were reactive. Conclusion: The hospital admission related to unspecified febrile syndrome constitute a challenge to the organization and the healthcare system to provide the best care for all and minimize its economic impact.