Cranio-cerebral invasive aspergillosis of sino-nasal involving the skull base is rare and associated with a very high mortality due to its peculiarly fulminant clinical course. We present an unusual case of 55-year-old diabetic female who initially treated for phytophotodermatitis, but later on she developed massive invasive cerebral aspergillosis. Advances in diagnosis and management of aspergillosis with improved and early detection and more effective therapy have promised some success in the management of these devastating infections.

Stroke following scorpion stings is rare and potentially fatal. Some case reports have been documented, especially in the Indian subcontinent. There is no published report of stroke as a complication of scorpion envenomation from South East Nigeria. Presented is the profile of an elderly woman with hemorrhagic stroke as a complication of a sting from a scorpion which was killed and thereafter ingested. A review of relevant literature is also made. An 83-year-old woman from a rural community was admitted in August 2011 at the University of Nigeria Teaching Hospital, Enugu with dysphasia, altered sensorium and right hemiparesis occurring 4 h after a scorpion sting to the left leg 2 weeks before presentation. Preceding the neurological deficits she had local pain and restlessness. She was not a known hypertensive or diabetic, but had been stung on two previous occasions by scorpions. It was customary to eat the scorpion if killed which was the case here. Systemic examination was remarkable only for drowsiness with a Glasgow Coma Scale of 11/15, mild right facial nerve palsy with ipsilateral spastic hemiplegia. Brain computed tomography scan done about 4 weeks after the ictus showed features consistent with a left intracerebral hemorrhage. She was managed conservatively and recovered motor functions over 3 weeks necessitating discharge. Since there was no other detectable risk factor, we can conclude that the patient suffered a stroke as a result of the vasculotoxic actions of the scorpion venom.

After the introduction of methicillin, Staphylococcus has evolved into a major cause of infection. We report a case of previously healthy middle-aged women with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) multiloculated empyema, which unmasked diabetes in her. There was no parenchyma involvement on chest X-ray as well as computed tomography scan, but only pleural cavity was involved, secondary to the bacteremia caused by skin lesion. CA-MRSA multiloculated empyema is rare, and it should be included in the differential diagnosis of the multiloculated empyema, as it can be lifesaving.