Scorpion sting and blindness: A case report.

Scorpion stings are one of the most common envenomations seen in the world. Rarely scorpion stings are known to cause a stroke. We report a case of a 60-year-old male, who presented with an unknown bite over the right middle finger which the patient revealed to be a scorpion sting, followed by altered sensorium and blindness. Brain imaging revealed an occipital infarct. This case report was written because scorpion sting causing an ischemic stroke is rare and ischemic stroke in the occipital region secondary to scorpion causing blindness has not been reported before.

Opsoclonus-myoclonus syndrome caused by organophosphate poisoning.

Opsoclonus-myoclonus syndrome is a combination of involuntary, arrhythmic, conjugate saccadic eye movements with myoclonus. The most common cause in adults is paraneoplastic encephalitis. Rarer causes include infections such as scrub typhus, and toxins such as organophosphates and cocaine. Organophosphates are one of the common poisonings in tropical countries such as India, causing both central and peripheral nervous system manifestations. We describe a middle-aged male farmer with unexplained altered consciousness and respiratory depression. After 2 days, he developed opsoclonus-myoclonus, and then bronchorrhoea and bradycardia, raising suspicion of organophosphate poisoning. After we had identified a very low serum cholinesterase concentration, he disclosed having consumed organophosphates.

Diagnosis of Undifferentiated Connective Tissue Disease in a Patient With Digital Gangrene and Positive Antinuclear Antibodies.

The occurrence of ischemia of the digits or digital gangrene is a well-known complication of systemic autoimmune diseases, such as systemic sclerosis, systemic lupus erythematosus, and anti-phospholipid syndrome, among others. The pathophysiological mechanisms are small vessel vasculitis, vasospasm of Raynaud's phenomenon, microthrombi due to antiphospholipid syndrome, and/or accompanying accelerated atherosclerosis. Digital ischemia can also occur in the context of disseminated bacterial infections and sepsis. We present here the case of a patient who had digital ischemia and positive antinuclear antibodies but without well-defined clinical features of a connective tissue disease. A diagnosis of undifferentiated connective tissue disease was made.

Abortion and Fulminant Idiopathic Intracranial Hypertension.

Idiopathic intracranial hypertension (IIH) causes visual involvement secondary to papilledema but rarely presents with acute gross diminution of vision. Anemia is associated with IIH. Acute hemorrhage-related anemia causing severe sudden onset bilateral visual loss due to IIH has not been previously reported. A 28-year-old female attempted the first-trimester abortion by self-administration of oral drugs. She presented with bleeding per vaginum, followed by bilateral visual loss. Symptoms pertaining to intracranial hypertension were mild. Examination revealed pallor, normal hemodynamic parameters, bilaterally dilated pupils, bilateral lateral rectus palsy, and only perception of light in both eyes. Lumbar puncture demonstrated high pressures; neuroimaging was noncontributory. Blood transfusion and supportive therapy in the form of acetazolamide and pulse methylprednisolone improved her vision in the right eye to six of 24; optic nerve sheath fenestration was performed in the left eye. During follow-up, her vision improved to six of 24 (right) and two of 60 (left), respectively. The IIH can present with severe acute onset bilateral visual loss even if features of raised intracranial pressure are minimal or absent. Immediate correction of anemia and supportive measures may significantly improve visual outcomes in fulminant IIH without the necessity of surgery.