Q.But how do you explain the lactic acidosis?

A. As you are suturing his wound you have a chance to get more history and he tells you that having been attacked in his own flat he ran as fast as he could to the police station – which was half a mile away – to get help.

His lactic acidosis was caused by the strenuous exercise!

Q. Is there anything else to worry about in this case?

A. He has been stabbed by the same knife as his friend – a huge version of a needlestick injury. They are both from a country with high prevelance of HIV, hepatitis B and C. They need counselling, urgent testing for blood borne viruses and accelerated course of Hep B vaccination.