Res Medica, May 1961, Volume II, Number 4

TABLE OF CONTENTSDEBILITY AND / OR LOSS OF WEIGHT Charles W. Seward, M.D., F.R.C.P.E.LEUKAEMIA James A. Barrowman, B.Sc.POISONING BY BRITISH PLANTS R. W. Corner, Esq.RES MEDICAAUSCULTATION OF THE HEART: Ill R. W. D. Turner, O.B.E., M.A., M.D., F.R.C.P.Ed., F.R.C.P.Lond. PARRY AND PARRY'S DISEASE R. I. Legge NUTRITIONAL BLINDNESS D. S. McLaren, M.D., Ph.D., D.T.M. & H.ACCIDENTAL HAEMORRHAGE James MowatEYE CHANGES IN DISSEMINATED SCLEROSIS A. D. ChalmersBOOK REVIEWSREFLECTIONS

Granulomatous Hepatitis in Association with Fever and a Palmar Rash

Secondary syphilis may present without the classical features of the disease and should be considered in patients acutely ill with abnormal liver function tests and a nonspecific pattern on liver biopsy. Secondary syphilis may present in association with granulomatous hepatitis and serological testing should be performed if the etiology of the hepatic granulomas is unclear. While the finding of a disproportionate elevation of alkaline phosphatase relative to serum bilirubin may be a useful pointer towards the diagnosis this pattern is not specific and not consistently observed. The definitive answer to the question of whether syphilitic hepatitis exists awaits the development of comprehensive rests to exclude viral pathogens

Acute Bloody Diarrhea with Right Sided Colitis

A 50-year-old woman presented with bloody diarrhea and radiological evidence of right sided colitis. Enterohemorrhagic Escherichia coli was isolated from the stool. The illness subsided spontaneously but was complicated by the development of hypoproteinemia and ascites. This disease presents a variable clinical picture but apparent 'ischemic colitis' in younger patients is especially suggestive of infection with E coli 0157:H7