When I was playing Penumbra Black plague, as soon as I ran in the room and picked up that item I heard "Is someone there?" In a demonic voice. I stuff my pants because there were never really other humanoids in that game. I loving ran out the door and saw that ugly thing and just sprinted away from it.
Penumbra is by far the most scary game I've played. Mainly because you cant use guns, you can only rely on brains rather then just blasting away at zombies...