DEAR EDITOR, Isothiazolinones, such as methylisothiazolinone (MI), the mixture of methylchloroisothiazolinone (MCI) and MI (MCI/MI), benzisothiazolinone (BIT) and octylisothiazolinone (OIT), are preservatives widely used in personal care products, cleaning materials, leather, glue, industrial chemicals and paints.The British Society for Cutaneous Allergy retrospectively audited data for January to October 2019 from clinical databases of nine UK dermatology units, assessing the frequency of sensitization to MI, MCI/MI, BIT and OIT. Patients with suspected allergic contact dermatitis were patch tested to MI 0Á2% in aqueous solution (aq.), MCI/MI 0Á02% aq., BIT 0Á1% in petrolatum (pet.) and OIT 0Á1% pet. (Chemotechnique Diagnostics, Vellinge, Sweden) in an extended baseline series. Readings were carried out on day 2 and day 4. Age, sex, atopy (atopic dermatitis, asthma and/or allergic rhinitis), site (s) affected (as many as applicable), duration of rash, and frequency of positive (1+/2+/3+), irritant and doubtful reactions were recorded.Nine centres (Bath,

SUMMARYA 49-year-old man presented to our department with an acute history of right leg tenderness, rash, swelling and fever. CT of the chest, abdomen and pelvis and a transoesophageal echocardiogram confirmed the diagnosis of mitral valve infective endocarditis with distal splenic emboli. Positive blood cultures revealed the causative organism to be Streptobacillus moniliformis. The patient was treated with high-dose antibiotics and had mitral valve replacement surgery. BACKGROUND

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