[A case of tsutsugamushi disease in the urban area of Komatsu City].

Most of patients with tsutsugamushi disease are diagnosed by their clinical histories suggesting the opportunities of Rickettsia infection in a rural region. We reported a 76-year-old female patient, who was considered to be infected in her house in the urban area of Komatsu City. She has shown typical clinical manifestations of tsutsugamushi disease, and was remitted successfully by oral administration of minocycline. Although specific antibodies to Rickettsia tsutsugamushi could not be detected in her serum by the complement fixation (CF) method during her clinical course, their significant elevation was confirmed by the indirect immunofluorescence (IF) method.

[Case of gastric cancer associated with acanthosis nigricans and meningeal carcinomatosis].

The patient was a 61-year-old man who initially complained of skin pigmentation. He was diagnosed as malignant acanthosis nigricans associated with gastric cancer (IIc advanced) in March 1981. Surgical excision of the stomach was performed in May 1981. In July 1981 he experienced headache, vomiting and muscle weakness. A diagnosis of meningeal carcinomatosis was made based on his clinical symptoms, spinal fluid examination and a computerized tomography scan. The intraventricular administration of cytosine arabinoside, methotrexate and hydrocortisone via the Ommaya reservoir resulted in complete remission. In November 1981 the patient died of bronchopneumonia and sepsis due to pancytopenia.

Subcutaneous fat necrosis associated with pancreatitis and gastric carcinoma.

Subcutaneous fat necrosis associated with acute pancreatitis in a 54-year-old man was reported. The acute pancreatitis was proved histologically after gastrectomy for coincident early gastric carcinoma. The patient was successfully treated with prednisolone and his skin lesions subsided within a month.