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A young man with acute lymphoblastic leukemia was treated with vincristine sulfate, prednisone, and intrathecally injected methotrexate sodium for central nervous system involvement. A good remission was induced, but three months later he had hepatosplenomegaly, an enlarging mediastinal mass, and progressive anemia. Histiocytic medullary reticulosis was confirmed by a bone marrow biopsy specimen. The patient died of respiratory failure because of infiltration of the lungs by malignant histiocytes.

Five patients with transvenous cardiac pacemakers had sustained staphylococcal bacteremia (defined as bacteremia for at least 12 hours) two weeks to ten months after pacemaker insertion. Three of the five patients had no evidence of an extravascular focus of infection at the time of stphylococcal bacteremia. An additional patient had a petechial rash, which is unusual in staphylococcal bacteremia, unless endocarditis is present. All patients were treated with antibiotics and drainage of the pacemaker packet when it was infected, removal of the pacemaker generator, or removal of the catheter electrode. One patient without evidence of pocket infection was treated successfully with antibiotic therapy alone.

Cellulitis caused by Diplococcus pneumoniae was diagnosed in two heroin users. To our knowledge, this medical emergency, clinically indistinguishable from deep fasciitis of pyomyositis, has not previously been reported as having been caused by the agent identified in these two patients.