Minerva: September 2002

A man aged 78 presented with an acute onset of thoracic kyphosis over a period of 10 weeks. During this time he found walking to be progressively more difficult, and he also had difficulty driving his car as he was unable to look far enough straight ahead. The differential diagnosis on magnetic imaging included the possibility of a neoplasm, but further investigations confirmed osteoporotic collapse. Rarely, osteoporosis can present as an acute onset of kyphosis.

Opioid addicts account for around a third of new cases of AIDS reported in the United States. Needle sharing cannot explain the high levels of infection in people who are addicted, says an article in the Journal of Infectious Diseases (2002;185:1826-9). It offers another possible explanation, reporting research on Rhesus monkeys which showed that those given opioids long term were more susceptible to simian immunodeficiency virus than those not given the drugs.

Scabies is known to be a pointer to the diagnosis of AIDS, and the association has been studied further in Brazil (AIDS 2002;16:1292-3). Severe, crusted scabies and Norwegian scabies should both arouse suspicion of retroviral infection with HIV or HTLV-1, or both.

Visitors to Mexico expect to get travellers diarrhoea, …