A 23-year old female was referred to our clinic for intermittent fever occurring over a period of eight years. Every time she developed fever, blood examination revealed elevated leukocytes and C-reactive protein (CRP). Antibiotics were always given based on elevated CRP with apparent improvement. However, the pattern of periodicity with absence of symptoms in between suggested periodic fever syndrome, particularly Familial Mediterranean Fever (FMF), which was later confirmed by mutation analysis. In Japan there is a tendency to use antibiotics solely based on "elevated CRP"; however, careful review of patient history is essential to identify FMF while avoiding the use of unnecessary antibiotics.

In order to determine the epidemiological features of cholera in Lao PDR, the presence of mobile genetic elements such as plasmid, class I integron and SXT element in V. cholerae isolated from surface water were examined. Among the 22 strains isolated from 13 distantly separated sampling sites, no mobile genetic elements associated with drug resistance were found reflecting the antibiogram of the strains. Nevertheless, cholera epidemics due to multiple drug resistant V. cholerae occurred repeatedly in those areas until 2000.