Cryptococcosis is a potentially fatal invasive fungal infection with considerable health challenges. A seemingly immunocompetent middle-aged man with frequent exposure to pigeons and bird excreta presented with headaches, fever, gait instability and diplopia. Two years prior to his presentation, he sustained a blunt head trauma which resulted in sporadic headaches. On examination, a hard scalp nodule measuring approximately 3 x 3 cm was palpable on the topmost part of his head. Cryptococcus neoformans was cultured from his cerebrospinal fluid, blood and the biopsied scalp nodule. A diagnosis of disseminated cryptococcosis was made, with the scalp lesion being designated as the primary source of the infection. Following a protracted course of antifungal therapy lasting 10 weeks, the patient was asymptomatic without any neurological deficits when reviewed in the clinic at two months postdischarge.

Vibrio vulnificus is a halophilic gram-negative bacillus that can cause fulminant septicaemia in immunocompromised patients. A 67-year-old man who was immunosuppressed as a result of cytotoxic chemotherapy presented with a brief history of fever, lethargy, myalgia, and reduced oral intake. He had recently travelled to the beach to consume seafood. His blood pressure was 81/47 mm Hg, necessitating fluid resuscitation followed by inotropic support and admission to the intensive care unit. His blood culture was positive for curved gram-negative bacilli. The isolate was oxidase-positive and produced an acid butt with an alkaline slant in triple sugar iron agar. Matrix-assisted laser desorption ionization-time of flight mass spectrometry conclusively identified the isolate as V. vulnificus. Intravenous ceftazidime plus ciprofloxacin were administered, and by the fifth day of admission, he was successfully transferred out to the general ward. In total, the patient completed a 14-day course of antibiotic therapy.