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Two women, aged 78 and 85 years, presented with watery diarrhoea and fever after a course of antibiotic therapy. Pseudo-membranous colitis was diagnosed, which was adequately treated. In both patients the C. difficile colitis relapsed, which was successfully treated with a pulse and tapering scheme of vancomycin. C. difficile infection is a frequent cause of antibiotic-associated diarrhoea. Clinical presentation can vary in severity. Cytotoxin testing, immunoassay and endoscopy are important tools in diagnosing C. difficile colitis. Like the first infection, the first relapse must be treated with metronidazole or vancomycin. To treat a second relapse, a pulse and tapering dose of vancomycin has been recommended. Nevertheless, multiple recurrences may occur, which are difficult to treat.

Infrared (IR) spectroscopy of chemisorbed C60 on Ag (111), Au (110) and Cu (100) reveals that a non-IR-active mode becomes active upon adsorption, and that its frequency shifts proportionally with the charge transferred from the metal to the molecule by about 5 cm-1 per electron. The temperature dependence of the frequency and the width of this IR feature have also been followed for C60/Cu (100) and were found to agree well with a weak anharmonic coupling (dephasing) to a low-frequency mode, which we suggest to be the frustrated translational mode of the adsorbed molecules. Additionally, the adsorption is accompanied by a broadband reflectance change, which is interpreted as due to the scattering of conduction electrons of the metal surface by the adsorbate. The reflectance change allows determination of the friction coefficient of the C60 molecules, which results in rather small values (∼2×109 s-1 for Ag and Au, and ∼1.6×109 s-1for Cu), consistent with a marked metallic character of the adsorbed molecules. Pre-dosing of alkali atoms onto the metal substrates drastically changes the IR spectra recorded during subsequent C60 deposition: anti-absorption bands, as well as an increase of the broadband reflectance, occur and are interpreted as due to strong electron–phonon coupling with induced surface states.

Q-fever occurs in The Netherlands in childhood more often than used to be believed. We treated an 8-month-old infant with congestive myocarditis associated with a seroconversion against Coxiella burnetii. The infection was probably caused by the father, who a few weeks earlier had visited his native Surinam, where he frequently was surrounded by domestic animals and drank raw cow's milk. After 2.5 years the child's general and cardial conditions are good although digoxin therapy is still necessary.

A patient on systemic amphotericin B therapy developed polyuria with low osmolarity of the urine probably due to nephrogenic diabetes insipidus. This rarely reported side effect of amphotericin B appears not to necessitate discontinuation of the treatment provided adequate fluid intake can be guaranteed. The diabetes insipidus is reversible in 2-6 months after cessation of the treatment: in our patient the polyuria and the low urine osmolarity disappeared within a few days.

The case-history of a 7-year-old boy with endocarditis, myocarditis and pericarditis, possibly caused by Coxiella burnetii (Q-fever), is presented. As far as we know only one case of Q-fever endocarditis in a child is previously described in literature. That child had, contrary to our patient, a pre-existing valve abnormality. Q-fever was diagnosed after demonstration of a significant rise in titer of the antibodies against Coxiella burnetii in both the IgM and the IgG fractions. IgA antibodies, indicative for an endocarditis, were also demonstrated.