The early stage of sporadic Creutzfeldt-Jakob disease is generally characterised by progressive changes in behaviour and intellectual function. While only a few patients have stroke-like onset, Creutzfeldt-Jakob disease with initial monoparesis has been described. In this report, a patient with an unusual sporadic Creutzfeldt-Jakob disease with typical magnetic resonance imaging findings, positive cerebrospinal fluid 14-3-3 brain protein, sharp-wave complexes in electroencephalogram, and initial right hemiparesis is reported.

A 50-year-old man with a history of protein S deficiency treated by long-term warfarin presented with right non-arteritic optic neuropathy. Following successful augmentation of warfarin to minimise the effect of thrombophilia, he had a recurrence in the right eye and involvement of the left eye 11 days after the initial onset. Further investigation showed a marginal blood lipid profile, which was treated with lipid-lowering agents. A combination of aetiologies was seen in this patient. Other unique factors, such as the short duration to recurrence and involvement of the fellow eye, are discussed.

Sudden deaths of children and adolescents during competitive sports are usually due to congenital heart diseases. Ventricular fibrillation, however, may also occur in individuals with no underlying cardiac disease who have sustained a low-impact chest wall blow. This phenomenon is described as commotio cordis, and the overall survival rate is poor. Successful resuscitation can be achieved by prompt cardiopulmonary resuscitation and early defibrillation. We report a teenager who sustained a chest wall blow that resulted in a cardiac arrest during a rugby competition. Cardiopulmonary resuscitation was given by bystanders. The ambulance crew arrived with an automated external defibrillator. Ventricular fibrillation was detected and responded to defibrillation. Subsequent investigations including imaging and electrophysiological studies did not reveal any cardiac or brain abnormality, and the patient recovered well neurologically. Accessible cardiopulmonary resuscitation-trained personnel and automated external defibrillators should be present at all organised sporting events.

Infantile cortical hyperostosis (Caffey disease) is a rare self-limiting inflammatory bony disease of early infancy. We report a 1-month-old Chinese boy with Caffey disease who presented with painful swelling over his shins bilaterally. Physical abuse was initially suspected, but the radiological findings of periosteal thickening over multiple bones (particularly the mandible), symmetrical involvement, diaphyseal involvement with sparing of the epiphysis, made Caffey disease a likely diagnosis. This report highlights that infantile cortical hyperostosis is an important differential diagnosis for children suspected of being abused, and clinicians should have a high index of suspicion to avoid misdiagnosis.

Liver abscesses are commonly caused by Enterobacteriaceae and anaerobes. This report is of a patient with liver abscess with massive haemolysis and multiorgan failure caused by Clostridium perfringens. Despite the reportedly high mortality rate and poor prognostic factors, the patient eventually recovered with prompt treatment.