A case of domestic violence is reported. The patient presented with the triad of injuries associated with the shaking of infants: retinal haemorrhages, subdural haematoma, and patterned bruising; this has been described as the shaken adult syndrome. This case report reflects the diYculties in diagnosing domestic violence in the accident and emergency setting.

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Malaria remains today one of the major health problems in the tropics with increased morbidity and mortality. The most serious complications are caused by Plasmodium falciparum, which, in contrast to the benign malarias, may progress to a life-threatening multi-system disease. Our case concerns a young woman in the 14th week of pregnancy, admitted to the ICU in a coma, with pulmonary oedema, haemolytic anaemia, renal failure and thrombocytopenia as complications of P. falciparum malaria. The case is discussed and possible explanations for the clinical picture and complications of P. falciparum malaria are given in the light of experiences from the literature.

Thoracic outlet syndrome (TOS) results from the compression of the subclavian vessels and the brachial plexus. Chronic compression of the vessels leads to pulmonary embolism (PE). We present our experience of two patients with PE due to TOS. Two patients (1 male, 1 female), both weightlifters, were admitted to our intensive care unit with severe hypoxaemia, dyspnoea and respiratory alkalosis. Both patients had a medical history of multiple attacks of chest pain and pain in the right arm. The clinical picture, a ventilation/perfusion scan and digital subtraction angiography confirmed the diagnosis of PE. We present this rare complication of the syndrome and give guidelines for optimal management and treatment.