Diagnostic criteria and core outcome set development for necrotising otitis externa: the COSNOE Delphi consensus study.

Objective: Evidence for necrotising otitis externa (NOE) diagnosis and management is limited, and outcome reporting is heterogeneous. International best practice guidelines were used to develop consensus diagnostic criteria and a core outcome set (COS).

Methods: The study was pre-registered on the Core Outcome Measures in Effectiveness Trials (COMET) database.

Retropharyngeal abscess from an unusual organism-Kingella denitrificans-in a patient on low-dose methotrexate.

Retropharyngeal abscess can be a life-threatening emergency with potential for airway compromise. We report a case of retropharyngeal abscess caused by Kingella denitrificans in a 66-year-old Caucasian man taking low-dose methotrexate for psoriatic arthritis. K denitrificans has not been previously reported as a cause of retropharyngeal abscess.

Outbreaks of hepatitis A in England and Wales associated with two co-circulating hepatitis A virus strains.

During 2002, an upsurge in frequency of hepatitis A outbreaks among injecting drug users was observed in England and Wales. As lack of risk factor information and the high mobility of the cases made linkage of outbreaks difficult, the relationship of nucleotide sequences in the VP1/2PA junction of the hepatitis A virus (HAV) genome amplified from serum of case-patients was investigated. A total of 204 HAV RNA positive sera obtained from a network of 23 laboratories were studied.

Doncaster: the public health response to a local cluster of heterosexually acquired HIV infection.

In recent years, clusters of sexually transmitted HIV infection have attracted some media prominence in the UK. We describe our response to a local HIV cluster of five cases that acquired a high media profile. Practical difficulties encountered included: ensuring medical confidentiality in an outbreak control team which included many professional groups; handling a large volume of helpline calls; differing views on how specific health promotion should be; and the impact of summer leave on the control team's continuity.