“Punk” rock can be bad for you: a case of surgical emphysema from a “punk” rocker’s leather jacket ▸

Stab wounds to the thorax are seen in the emergency department and can be caused in a variety of ways. This case highlights an unusual cause of injury – a leather jacket with spikes on the back of it. This type of jacket is often worn by “Punks” as a fashion statement. We report that falling onto such a jacket may result in accidental thoracic injury leading to subcutaneous emphysema. A thorough clinical assessment is mandatory to exclude underlying lung injury or pneumothorax. In patients with subcutaneous emphysema and an otherwise normal chest x ray an in-hospital observation period of 24 hours, to observe for any delayed complications, is adequate if the patient remains clinically stable.

An unusual presentation of sphenoid sinusitis with septicaemia in a healthy young adult ▸

A 42 year old man presented with a two week history of worsening headache and high temperature. Physical and neurological examinations were unremarkable.

A full septic screen including lumbar puncture was preformed which showed a raised WBC and CSF with no growth. Chest x ray was normal and blood cultures were positive for Haemophilus influenzae.

The patient made a remarkable improvement on intravenous antibiotics and was …