New cannula for intermittent and continuous venous sampling without heparinisation.

IgM 5-6 gll. Abdominal computed tomography (CT) showed multiple cysts in the liver 2-3 cm diameter and cysts in the spleen and posterior abdominal wall. Pulmonary cysts were seen on chest radiography. She began treatment with mebendazole, the dose increasing to 250 mg thrice daily. On the tenth day she became unwell, with a swinging fever and pleuritic left upper-quadrant abdominal pain. This area was acutely tender to palpa-tion. Mebendazole was stopped and the pain and fever gradually settled over 10 days without antibiotics. Extensive laboratory investigations failed to uncover any infective cause and there was no change in renal or hepatic function. Mebendazole was reinstituted for a further four weeks without mishap in a dose of 20 mg/kg daily. At follow-up three months after the course of mebendazole the abdominal distension was greatly reduced and the liver smaller and softer than before. Case 2-A 35-year-old Saudi woman had a long history of abdominal distension, which had recently become more severe. Extensive hydatid disease had been found at laparotomy in Saudi Arabia. Examination in London showed enormous abdominal distension with numerous palpable cystic lumps. The laparotomy wound was incompletely healed and extruded small hydatid cysts. Her haemoglobin concentration was 12-1 g/dl and erythrocyte sedimentation rate 87 mm in first hour. Blood urea, blood glucose, and plasma bilirubin concentrations were normal, as were serum alkaline phosphatase and serum aspartate aminotransferase activities. Serum albumin concentration was 33 g/l and total protein 91 g/l. Abdominal CT showed multiple hydatid cysts in the liver, spleen, and peritoneal cavity. Mebendazole was given in increasing doses, and after four days' treatment she developed a swinging fever, which persisted after the drug was stopped (figure). Extensive laboratory investigations failed to uncover