A retrospective study of 32 patients with primary tumours of the cauda equina is presented. Most of the patients were initially diagnosed as having prolapsed intervertebral discs and freated accordingly. The correct diagnosis was eventually made, usually after a long delay, and confirmed by myelography. Treatment consisted of laminectomy and excision of the tumour. Only one tumour was frankly malignant; all the remaining patients were relieved of their pain and the majority recovered completely. The exceptions were those patients with long-standing neurological deficits; this highlights the importance of early

Meningococcal septicaemia may present as an acute vasculitis without any features of bacterial infection. It is therefore advisable that in a patient with generalized features of an acute hypersensitivity reaction requiring steroid therapy, concurrent antibiotic treatment should be considered even if blood cultures and swabs are negative. References 1 Goldacre MJ, Miller DL. Completeness of statutory notification for acute bacterial meningitis. Brit Med J 1976;ii:501-3 2 Stephani U, Bleckmann M. Rare complications in a case of generalised meningococcal disease: Immunological reactions versus bacterial Metastasis. Infection 1982;1:23-7 3 Sotto MN, Langer B, Hoshino-Shimizu S, Brito T. Pathogenesis of cutaneous lesions in acute meningococcocaemia in humans; light immuno-fluorescent and electron microscopic studies of skin biopsy specimens.

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