Bacteraemia in salmonellosis: a 15 year retrospective study from a regional infectious diseases unit.

diuretics; three from progressive cholestasis (two of whom had ascites only in their final weeks of life); and one from chronic hepatic encephalopathy -(without ascites) and bronchopneumonia.Six of the eight patients with a very high initial plasma methionine enkephalin concentration (530-1310 pmol/l) died compared with only one of the 26 patients with lower initial concentrations (50-365 pmol/l; p<0 001, Fisher's exact test).In the six patients with a high initial concentration who died the concentration remained over 500 pmol/l (p<005) whereas in the two who survived it fell to less than 200 pmol/l.The two survivors had ascites when initially tested.They responded well to diuretics and remained free of fluid overload.We thank Dr A D Clayden of the department of com-