The Colombian epidemiological profile has transcended to chronic diseases since life expectancy has increased substantially, especially in large cities. (1,2) Nevertheless, infectious diseases caused by pathogens, viruses, bacteria, fungi and parasites persist in some areas of the country.

Introduction: Gastroschisis is a low-prevalence disease with a very good prognosis, if initial management is adequate. This paper attempts to describe the disease and highlight the importance of correct treatment at the primary care level. Case presentation: Newborn child diagnosed with gastroschisis in a primary care center, referred to the Neonatology Service of a tertiary care institution. He received interdisciplinary management and underwent gradual surgical closure, with favorable outcome after a three-month hospitalization. Discussion: There is no clarity about the exact cause of gastroschisis, since it is a multifactorial disease. It can be diagnosed during the prenatal stage by means of ultrasonography, which has high sensitivity and specificity for its detection. Conclusion: Gastroschisis is a disease that requires adequate knowledge from both specialized and primary care personnel, as it ensures a correct initial management and avoids future complications.

Introduction: Super-refractory status epilepticus (SRSE) is a pathology that affects the neuronal environment depending on the types of seizure and their duration. Case presentation. This paper presents the case of a 7-year old child presenting with super-refractory status epilepticus and multifocal seizures. Metabolic, structural, infectious, toxicological and autoimmune causes were discarded, while different anticonvulsive agents were administered without any clinical improvement; seizures were controlled 6 weeks after admission to ICU. A 12-year follow-up was performed, during which time the patient presented recurrent status epilepticus with autonomic seizures and progressive cognitive decline. Discussion: This type of status epilepticus is part of the syndrome known as Febrile Infection-Related Epilepsy Syndrome (FIRES), a possibly autoimmune form of epileptic encephalopathy that is refractory to acute and chronic management. There is no report in the literature that includes long term follow-up, therefore, there is no actual consensus about the appropriate management of the chronic phase of the disease. Conclusion: FIRES must be considered as one of the possible etiologies of super-refractory status epilepticus, so early management strategies (like ketogenic diet) can be used in order to achieve control of the critically ill patient, control long term seizures and improve cognitive outcomes, having as the final result a positive impact on the quality of life of the patient.

Introduction: Purulent pericarditis is an inflammatory process in the pericardium caused by bacterial infection. If experienced during childhood and with untimely diagnosis, it has a high mortality rate. Case presentation: A 10-month-old infant was admitted to a high complexity pediatric hospital in the city of Bogotá D.C, Colombia, due to clinical symptoms including cough, respiratory distress and fever. A chest x-ray was taken showing cardiomegaly and multilobar pulmonary involvement. The echocardiogram showed global pericardial effusion managed with pericardiotomy, in which 50 mL of turbid fluid with whitish membranes was obtained. Cytochemical test revealed 2 600 mm3 leukocytes with 90% PMN and protein elevation. Purulent pericarditis was diagnosed based on imaging and laboratory findings. Treatment was initiated with ceftriaxone and clindamycin for four weeks, obtaining effective clinical and echocardiographic resolution. Discussion: The clinical presentation and imaging, paraclinical and electrocardiographic findings suggested purulent pericarditis as the first possibility. This diagnosis was confirmed considering the characteristics of the pericardial fluid, which was compatible with an exudate. Clinical resolution supported by antibiotic management corroborated the diagnosis, even though microbiological isolation was not obtained in cultures. Conclusion: Purulent pericarditis is a rare disease in pediatrics and has a high mortality rate. Making a timely diagnosis and administering early treatment are related to a better prognosis of this pathology.

Introduction: Bouveret syndrome is a rare form of gallstone ileus that causes gastric obstruction due to the presence of a gallstone in the pylorus or duodenum, secondary to biliodigestive fistula. This condition is difficult to diagnose and one of its main complications is hemorrhage in the digestive tract. Two-stage surgical management is recommended, although it can also be managed through upper endoscopy in gallstones smaller than 2.5cm. Prognosis and postoperative period are good. Clinical case: 63-year-old patient with a clinical picture of 15 days of pain in the epigastrium and bilious vomiting. Imaging showed a calcified mass in the second part of the duodenum, which was surgically treated by entering the jejunum, performing an enterotomy and extracting the gallstone. The patient was discharged on the fifth day without any symptoms. Conclusion: Bouveret syndrome is a rare entity that requires better medical assessment and ancillary imaging techniques to achieve a timely diagnosis.

Introduction: Neurocysticercosis (NCC) is the result of ingestion of pork tapeworm eggs (Taenia solium) from an individual with taeniasis (taeniasis/cysticercosis complex). This disease causes the highest helminthic-related morbidity and mortality rates due to its deleterious effects on the central nervous system. 80% of the cases can be asymptomatic and 20% show non-specific clinical manifestations. Case presentation: The following report presents the case of a patient with headache, dromomania, intracranial hypertension syndrome, and cognition and gait impairment. A brain CT showed a right frontal subcortical cyst and bilateral frontoparietal calcified nodules. Neurocysticercosis of the frontal lobe was suspected as the main diagnosis considering the clinical manifestations, anamnesis and local epidemiology. Discussion: T. solium reinfection in the right frontal lobe was suspected in this patient due to perilesional edema, calcified nodules randomly distributed on the imaging and the information supplied by his relatives during anamnesis. Symptoms and signs of NCC depend on localization, number, dimensions, cysticercus stage (vesicular, colloidal, granular-nodular and calcified nodule), genotype and immune status of the host. Between 60 and 90% of cysticerci are mainly observed in the brain parenchyma, but other less frequent localizations include ventricles, subarachnoid space, eyes, meninges and spinal cord. Conclusions: It is important to know and educate the community about the life cycle of parasites, epidemiology, prevention measures and clinical manifestations of neurocysticercosis in order to make a timely diagnosis and administer an effective treatment.

Introduction: Hemangiopericytoma is a rare vascular tumor of the sinonasal region, associated with epistaxis and nasal obstruction as the main symptoms. When located in this region, it has special clinical characteristics that differentiate it from others. Case presentation: The following paper reports the case of a 43-year-old female patient presenting with right nasal obstruction and 6 months of evolution associated with mucopurulent rhinorrhea and recurrent right side epistaxis. Physical examination showed a right obstructive mass originating from the cribriform plate. Computed tomography of the paranasal sinuses revealed a complete blockage of the right nasal cavity by a homogeneous content, with soft tissue density and no evident contrast enhancement. The lesion extended superiorly to the cribriform plate but without intracranial or orbital extension. The patient was treated with endoscopic surgery and anatomopathological study revealed sinonasal hemangiopericytoma. The patient had complete remission and subsequent 3-year follow-up without recurrence. Conclusion: The recommended treatment for hemangiopericytoma is total surgical excision with free margins. The results are generally good and the risk of recurrence seems to be associated with incomplete tumor excision. A literature review is presented and its main characteristics are discussed.

Introduction: Cystic tumors of the neck are rare in adults. Some of them include metastatic nodes, branchial cysts, thyroglossal cysts and lymphangiomas, among others. Clinically speaking, lymphangiomas are slow-growing soft masses located in different spaces of the neck. Case report: This paper reports the case of a 36-year-old woman presenting with lymphangioma, who consulted due to a right lateral mass in the neck of 20 days of evolution without associated systemic symptoms. Although relapse is frequent, the patient was successfully treated with surgery, without evidence of recurrence at 12 months of follow-up. Discussion: When cystic tumors of the neck occur in children, surgical urgencies may arise due to obstruction of the airway. However, lymphangioma in adults only produce contour deformity and rarely require urgent intervention, which allows for conservative management such as observation, repeated drainage or sclerotherapy that can be done using OK-432 (Picibanil). Nevertheless, surgery remains a good treatment option, but some complications may occur. Conclusion: Different treatment options were reviewed, which led to conclude that surgical resection of lymphangiomas continues to be a good treatment for this complex neck lesion.

Introduction: Colonic atresia is the least common type of intestinal atresia; however, it must be suspected in patients with partial or complete intestinal obstruction, failure to pass meconium, vomit and abdominal distension. Good prognosis has been described in patients with timely treatment. Case report: This paper reports the case of a newborn patient presenting with vomit, abdominal distension, failure to pass meconium and a rapid progressive clinical deterioration. A colonic atresia was found during exploratory laparotomy, which required a temporary colostomy due to the discrepancy of the proximal and distal calibers. Subsequently, colonic anastomosis was performed using a protective colostomy that was finally closed. This patient had a good post-operative recovery. Conclusion: Colonic atresia must be considered as an important cause of distal intestinal obstruction in pediatric patients and, therefore, it should always be suspected. Ruling out other associated abnormalities is also recommended, as well as performing a rectal biopsy for Hirschsprung’s disease to avoid complications.

Introduction: Toxocariasis is a zoonosis caused by the Toxocara canis and Toxocara cati nematodes larvae. These are intestinal parasites found in canids and felids, respectively. Case presentation: This paper presents the case of a 22-year-old woman from Caquetá, with a three-month history of vision loss in her left eye, eye pain, diplopia, photophobia and bilateral red eye. Retinal detachment in the left eye was diagnosed by ultrasound. The ophthalmology service made a differential diagnosis of retinoblastoma and pars planitis. Symptomatic management was initiated with oral and topical corticosteroids, obtaining symptom improvement, although loss of visual acuity persisted. Discussion: Coexistence and cohabitation of the patient with pets (dogs and cats) was an important factor to consider ocular toxocariasis. Complete blood count revealed mild leukocytosis and lymphocytosis without eosinophilia. Antibodies against Toxoplasma gondii and Taenia solium cysticercus were negative, as well as the VDRL. The ELISA test for Toxocara canis was positive, with IgG titers of 1:64 (positive =1:32, specificity >90%). Management with ophthalmic and systemic corticosteroids, albendazole and vitrectomy was initiated. The vitreous band was released by means of surgery, making the diplopia disappear, although residual peripheral granuloma persisted and will be operated by ophthalmology.