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A 62 year old female presented to the acute medical team with headache, fevers and enlarged axillary lymph nodes. Initial biochemical, microbiological and immunological investigations were normal. However, radiological imaging revealed that her silicone breast implants had ruptured, which may have been responsible for her presentation. A brief overview of the clinical features and management of silicone breast implant rupture is provided.

A 79-year-old woman presented to the accident and emergency department with a short history of central chest pain radiating to the arm and epigastrum, associated with vomiting. There was no history of haematemesis and no recent change of bowel habit or melaena. She had a myocardial infarction 4 months previously and had a metal prosthetic mitral valve replacement for which she was anticoagulated with warfarin, maintaining an INR between 2.5– 3.5. On examination she appeared pale, but there were no other abnormal findings; the liver was not enlarged or tender.