CVE-2025-58092 is a reflected cross-site scripting vulnerability categorized under CWE-79, affecting MedDream PACS Premium version 7.3.6.870. The vulnerability resides in the config.php script, where the 'phpexe' parameter fails to properly neutralize user-supplied input before embedding it into the web page output. This improper input sanitization allows attackers to craft malicious URLs containing JavaScript payloads that execute in the victim's browser when the URL is accessed. The attack vector is remote and requires no privileges or authentication, but does require user interaction to click or visit the malicious URL. The vulnerability impacts the confidentiality and integrity of user sessions by enabling theft of cookies, session tokens, or manipulation of displayed content, potentially leading to further attacks such as session hijacking or phishing. The CVSS 3.1 base score is 6.1, reflecting medium severity with network attack vector, low attack complexity, no privileges required, but user interaction necessary. No known exploits have been reported in the wild, and no patches have been officially released, increasing the urgency for defensive measures. Given that MedDream PACS is a medical imaging and archiving system, exploitation could impact sensitive patient data confidentiality and trust in healthcare IT systems. The reflected nature of the XSS means the attack is transient and requires active user engagement, but the potential for targeted spear-phishing campaigns exists.

For European organizations, particularly healthcare providers using MedDream PACS Premium, this vulnerability poses a risk to patient data confidentiality and system integrity. Successful exploitation could allow attackers to steal session cookies or credentials, enabling unauthorized access to sensitive medical images and patient records. This could lead to privacy violations, regulatory non-compliance (e.g., GDPR breaches), and reputational damage. Additionally, attackers might manipulate displayed information, potentially causing clinical misinterpretation or disrupting workflows. The requirement for user interaction limits mass exploitation but does not eliminate risk, especially in environments where users may be targeted via phishing. The absence of patches increases exposure time, and the critical nature of healthcare data elevates the threat's significance. Organizations may also face legal and financial consequences if patient data is compromised. The reflected XSS could be leveraged as a foothold for more advanced attacks within the healthcare network.

1. Immediately implement strict input validation and output encoding on the 'phpexe' parameter in config.php to neutralize malicious scripts. 2. Employ web application firewalls (WAFs) configured to detect and block reflected XSS payloads targeting MedDream PACS URLs. 3. Educate healthcare staff about the risks of clicking suspicious links, especially those purporting to be related to PACS or medical imaging systems. 4. Monitor web server logs for unusual URL patterns that may indicate attempted exploitation. 5. Isolate the PACS web interface behind secure network segments with limited external exposure. 6. Use Content Security Policy (CSP) headers to restrict the execution of unauthorized scripts in the PACS web application. 7. Coordinate with MedDream vendor for timely patch deployment once available. 8. Consider implementing multi-factor authentication to reduce the impact of stolen session tokens. 9. Regularly update and audit the PACS environment for security misconfigurations. 10. Prepare incident response plans specific to web application attacks targeting healthcare systems.