We report here a case of lead poisoning in a 20 month old girl who presented with acute encephalopathy and status epilepticus. The major clues leading to the diagnosis were the occupational family history and dense lead lines on X-ray of the long bones. She showed evidence of neurological dysfunction in the initial phase, but she improved steadily, regaining her motor power partially and her vision, although some cognitive and language deficits were already evident. She will need long-term neurological assessment and evaluation to ascertain the extent of permanent brain damage.
A 73-year-old Chinese man was admitted to the Accident and Emergency Premorbid Ward of a local hospital in Malaysia. The patient complained of shortness of breath with cough and was in a semi-conscious state. He was later admitted to an intensive care unit (ICU) of the hospital. Six days after admission 5-6 maggots were recoverd from the nasal cavity. The maggots were identified as the third-instar larvae of Lucilia cuprina Wiedmann (Diptera: Calliphoridae) based on the morphological characteristics. This patient was classified as having nosocomial myiasis. The presence of the third instar larvae indicated that the infestation was not more than three to four days. An adult sarcophagid identified as Parasarcophaga ruficornis (Fabricius) caught in the ICU where the patient was warded provided further evidence of the potential for the nosocomial infestation.