Recurrent arthritis: an unusual diagnosis.

Musculoskeletal complaints may be the initial manifestation of childhood leukaemias. When these symptoms predominate at the onset, a diagnosis of one of several rheumatic diseases may be entertained. Where blood tests are normal, no bone marrow examination would normally be indicated. The use of immune-suppressing medication, such as steroids, may lead to diagnostic delay or misdiagnosis.

Cephalic Tetanus Presenting as Ptosis.

A 7-year-old unimmunized boy developed cephalic tetanus following chronic suppurative otitis media. We wish to emphasize that possibility of cephalic tetanus should be considered in an unimmunized child presenting with ptosis.