Michael Riste, Specialty registrar in infectious diseases and general internal medicine and George Trafford, Specialty registrar in infectious diseases and microbiology Heartlands Hospital, Birmingham, UK Heartlands Hospital, Birmingham, UK Editor – I read with interest ‘Lesson of the month 1: A rare adverse reaction between flucloxacillin and paracetamol’, published in March's Clinical Medicine, and write with a similar case seen recently in our institution, to further highlight this issue.