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A 34-year-old man, homosexual, came to the clinic of venerology due to severe perianal pain. When examinated, small, eroded vesicles were found perianally. This was interpreted as a primary herpes infection. At the follow-up visit, several vesicular and papular elements were now present on the body. The patient tested positive for mpox. This case confirms that mpox is a relevant differential diagnose in venerology in Denmark.

Sepsis is the terminal event for most infectious diseases and is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis is frequent, deathly and associated with high burden for patients, relatives and societies. Sepsis is underreported in diagnostic coding, making estimation difficult of the true burden of the disease in Denmark. It is likely, however, that sepsis contributes to 15% of all deaths in Denmark.

Ten and seven years ago respectively, the two high-isolation units in Denmark became prepared to receive highly contagious and potential severely ill patients. The units are located in the departments of infectious diseases in Hvidovre Hospital and Aarhus University Hospital. Both departments had little experience until the Ebola outbreak in West Africa, 2013-2015. Altogether, 15 possible Ebola patients were examined in the two departments, but the diagnosis was ruled out for all of them. Besides, a few possible candidates for Middle East respiratory syndrome patients were examined. Always being prepared in a busy clinical everyday environment is a challenge, and it takes regular training and exercises involving all personnel.

In Denmark, oocyte donation is allowed for women below 46 years of age if sperm from the woman's husband/partner is used, thus assuring genetic relationship with one parent. New legislation has provided more donors implying both shorter waiting time until treatment and more pregnancies achieved with donated oocytes. Oocyte donation pregnancies have increased risks of pre-eclampsia, post-partum bleeding, caesarean section, low birth weight and preterm birth, and since these risks are aggravated in multiple pregnancies, single embryo transfer is recommended.

The largest Ebola epidemic ever is about to end. No major breakthrough in terms of specific treatment has been seen, but a number of valuable lessons have been learned, including the potential of intensive supportive care. New products are under development, but clinical trials were initiated late in the epidemic leading to inability to include sufficient numbers. Several large vaccine trials are underway with one vaccine so far showing 100 per cent efficacy. A paradigm shift in accelerated testing of drugs and vaccines during an ongoing epidemic is emerging.

Autosplenectomy is a rare phenomenon in patients with systemic lupus erythematosus (SLE). We present a case of pneumococcal septicaemia in an SLE patient. A CT-scan of the abdomen showed complete autosplenectomy, but a CT scan from years prior showed a normal size spleen. SLE patients have an increased risk of invasive pneumococcal disease and asplenia increases this risk. In Denmark there are no guidelines for vaccination of SLE patients. On the basis of this case report and the guidelines from European League Against Rheumatism we propose that the 23-polyvalent pneumococcal vaccine should be part of the standard regime in the management of SLE.

A 37-year-old woman with body mass index > 30 was admitted to hospital with severe pneumonia due to H1N1v. Thoracic X-ray showed bilateral, diffuse infiltrates. There was no sign of complicating bacterial infection and all microbiological tests of tracheal secretion, blood and urine were negative. Polymerase chain reaction test for H1N1v was positive until day ten. No mutations were found in the virus. The patient was given oseltamivir tablets and inhalable zanamivir as well as antibiotics. The patient was treated with extra-corporal membrane oxygenation (EcmO) for 12 days followed by ventilator weaning. The patient had no neurological sequelae.

Crush syndrome or traumatic rhabdomyolysis constitutes the systemic changes seen after crush injury, i.e. the damages seen after a prolonged period of pressure on a muscle group. The pressure causes necrosis of muscle, and during revascularisation diffusion of calcium, sodium and water into the damaged muscle cells is seen, together with loss of potassium, phosphate, lactic acid, myoglobin and creatinine kinase. Untreated these changes can lead to: hyperkalaemia, acidosis, acute renal failure and hypovolaemic shock. Treatment of the systemic changes should be initiated immediately, aiming at a rapid correction of the extracellular volume and forced mannitol-alkaline diuresis. If renal failure develops, haemodialysis is started. The crush injuries are treated conservatively without fasciotomy, despite high or increasing intracompartmental pressure. The only indications for fasciotomy are lack of a distal pulse or open lesions. If fasciotomy is performed, radical removal of all necrotic muscle is essential.

A 43-year old man with alcohol abuse had septicaemia with Salmonella enteritidis. After osteosynthesis of an intertrochanteric femoral fracture he developed a deep wound infection with Salmonella enteritidis. The patient was treated with surgical debridement and antibiotics. As a consequence of alcohol abuse the patient may have had a predisposing immunosuppression, and infection with Salmonella enteritidis should be considered in case of postoperative infection in these patients.

A case of meningitis in a 42-year-old previously healthy man caused by the gram-negative rod Capnocytophaga carnimorsus is presented. The patient had erythema nodosum. Bacteremia was possibly induced during dental treatment.