A case of epididymitis associated with Panton-Valentine leukocidin Staphylococcus aureus.

A new pattern of disease caused by Panton-Valentine leukocidin (PVL)-positive strains of Staphylococcus aureus is emerging in the UK and worldwide. Community-associated methicillin-resistant S aureus (MRSA) is more likely to produce PVL, a pore-forming cytotoxin inducing leucocyte lysis, which often infects young healthy individuals. The worldwide emergence and continually increasing prevalence of community-acquired PVL-MRSA have recently attracted high-profile media attention and prompted concern regarding the transmissibility and virulence. This paper reports a case of genitourinary tract infection associated with PVL-positive community-associated MRSA in an immunocompetent young man.

Haemorrhagic acute disseminated encephalomyelitis: an unusual case of blindness in an HIV-infected patient.

Acute disseminated encephalomyelitis (ADEM) is a monophasic, polysymptomatic, immune-mediated demyelinating disorder involving central nervous system (CNS) white matter. It is usually seen in association with exanthematous viral illnesses, systemic infections or vaccinations. The haemorrhagic form of ADEM is rarer and follows a more fulminant course. We describe a case of haemorrhagic ADEM in an HIV-infected patient presenting solely with acute onset bilateral blindness and normal retina. ADEM was diagnosed from clinical, laboratory and radiological findings. Although ADEM has been seen with HIV seroconversion illness and in chronic infection, the haemorrhagic form has never been reported in association with HIV. Acute onset blindness is extremely rare in HIV-positive patients. A Medline search revealed very few reports. The importance of considering haemorrhagic ADEM as aetiology of blindness in such a scenario is discussed.