Erythrocyte transketolase activity and the effect of adding thiamine pyrophosphate (% thiamine pyrophosphate effect) were measured in 111 subjects suspected to suffer from Leigh's disease (subacute necrotising encephalomyelopathy). From clinical evidence these subjects were divided into five groups: (1) necropsy-proved cases of subacute necrotising encephalomyelopathy, (2) cases positive for ur...

BACKGROUND Descending necrotising mediastinitis is caused by downward spread of neck infection and has a high fatality rate of 31%. The seriousness of this infection is caused by the absence of barriers in the contiguous fascial planes of neck and mediastinum. METHODS The recent successful treatment of seven adult patients with descending necrotising mediastinitis emphasises the importance of...

Necrotising fasciitis is a rapidly progressing necrotising process involving subcutaneous tissue and fascia but sparing muscles, and is accompanied by severe systemic toxicity.1 2The syndrome is often caused by group A streptococci,' 3 but it is now recognised that other bacteria may be involved, usually in mixed culture. Organisms that have been implicated include a variety of anaerobes, enter...

Osteoma of external auditory canal is a rare benign tumour. Usually slow growing, found incidentally and often symptomless. Rarely an osteoma may present as a simple aural polyp and may be mistaken as polyps arising secondary to tuberculous,chronic otitis media or carcinoma. The presentation of an osteoma as an aural polyp is extremely rare, and there have been very few reports published Here w...

Fulminant necrotising amoebic colitis is a complication of untreated amoebiasis. This is seen in mainly low-income countries. It has a high mortality rate and is difficult to diagnose. We present an extremely rare case of fulminant necrotising amoebic colitis that caused diagnostic confusion in mimicking an acute abdomen, presumably caused by a perforated duodenal ulcer.

Two patients with food starch granulomatous reactions, one a necrotising granulomatous peritonitis after the perforation of a gastric ulcer and the other a non-necrotising granulomatous appendicitis, are described. The possibility of food starch induced inflammation must be considered in the differential diagnosis of granulomatous diseases of the gastrointestinal tract.

Necrotising pneumonia caused by Panton-Valentine Leukocidin Staphylococcus aureus confers a high mortality. We describe a child presenting with sepsis and necrotising pneumonia. Septicaemia caused by Panton-Valentine Leukocidin Staphylococcus may not be adequately treated with antibiotics to which it appears sensitive through standard culture techniques. Some evidence suggests that early anti-t...