A 21-year-old man had a long-standing history of leg ulcers and hyperpigmention over the feet. Over a span of 8 months, he had an acute ischemic stroke followed by a basal ganglia hemorrhage. He was finally diagnosed with DADA2 syndrome after genetic sequencing. The implications of this new syndrome and its links to stroke in the young are presented in this article.

Emphysematous pyelonephritis is a rare and severe infection of the kidney, which is characterized by necrotising changes in the renal parenchyma and accumulation of gas in the peri-renal tissue. The causative organism is usually a gas forming gram negative bacteria. We present a case of 65 years old gentleman presenting with leg pain, little lower urinary tract symptoms of fever, referred to our hospital with a renal mass requiring nephrectomy. He was subsequently diagnosed as EPN, requiring aggressive antibiotic therapy, haemodialysis, fasciotomy and surgical debridement. This case highlights the timely interventions required by multiple specialities and aggressive management including surgical intervention essential for an acceptable recovery. We have also tried to understand the pathophysiology of the disease and why it responds poorly to treatment.

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We present a 36-year-old immuno-compromised male with non-resolving pneumonia, who developed a broncho-pleuro-cutaneous fistula following a thoracoscopic biopsy, which was successfully managed with an ultrasound-guided blood patch placed over the bronchial defect. We discuss the mechanism by which this is presumed to close a fistula, thus justifying it as a cost effective and minimally invasive modality of treatment.