Aggressive -negative peptic ulceration as the initial manifestation of Crohn's disease.

Peptic ulceration is a recognised feature of Crohn's disease, but the characteristics of this manifestation are rather poorly described. Furthermore, most reports in the literature relate to ulcer disease in cases of established Crohn's disease. The authors report a series of four cases in which the diagnosis of Crohn's disease was preceded by peptic ulceration.

Aspergillosis of the petrous apex.

We present the case of an immunocompetent man who presented with multiple and progressive cranial nerve palsies. The cause was found to be aspergillosis of the petrous bone, arising as a result of chronic fungal otitis media. Despite treatment with local excision and systemic anti-fungal therapy, he died after suffering a subarachnoid haemorrhage.