Pentastomiasis in Canada.

We report a case of human pentastomiasis in a 28-year-old man who emigrated to Canada from Nigeria in 1982 and died as a result of a motor vehicle accident in 1989. At autopsy, in addition to trauma, numerous small cystic nodules (3 to 9 mm in diameter) were discovered in the liver, pleura, lungs, and mesentery and under the intestinal and parietal peritoneum. The parasites were diagnosed as well-preserved, encysted Armillifer armillatus nymphs. Neither degenerative nor inflammatory granulomatous reactions were observed in the adjacent tissue. To our knowledge, this is the first reported case of human infection with encysted nymphs of A armillatus and the eighth reported case of pentastomiasis in North America.

Fatal necrotizing mediastinitis secondary to acute suppurative parotitis.

A unique case of fatal necrotizing mediastinitis secondary to acute suppurative parotitis is reported. The infection was the result of synergistic necrotizing cellulitis caused by mixed aerobic and anaerobic bacteria. To the best of the authors' knowledge, this is the first reported case of necrotizing mediastinitis resulting from a descending acute suppurative parotitis. Acute parotitis should be included in the broad spectrum of infections resulting from synergism between aerobic and anaerobic bacteria in which anaerobes indigenous to the oral cavity predominate.

Fat embolism in acute pancreatitis.

A patient who developed progressive hypoxemia and multiple system failure during the course of acute pancreatitis is described. Autopsy showed fat emboli to the lungs, kidneys, and heart, as well as multiple petechial hemorrhages in the brain. We conclude that fat embolism should be considered in the differential diagnosis of progressive hypoxemia in patients with acute pancreatitis.