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Left paraduodenal hernia is an entrapment of the small bowel into the Landzert fossa, an unusual congenital peritoneal defect behind the descending mesocolon that results from failure of part of the descending mesocolon to fuse with the posterior parietal peritoneum (Doishita et al. in Radiographics, 36(1): 88-106, 2016). This fossa is reported to be present in approximately 2% of autopsy bodies. The authors present a case of a left paraduodenal hernia in a young woman. [ABSTRACT FROM AUTHOR]

Acquired bronchoesophageal fistula can have their origin in a benign or malign cause. Benign bronchoesophageal fistula is rare and often associated with nonspecific symptoms that may delay the correct diagnosis. The authors present a case of a bronchoesophageal fistula in a 57-year-old woman caused by tuberculosis infection. [ABSTRACT FROM AUTHOR]

Polymyxin-carbapenem-resistant Klebsiella pneumoniae (PCR-Kp) with pan (PDR)- or extensively drug-resistant phenotypes has been increasingly described worldwide. Here, we report a PCR-Kp outbreak causing untreatable infections descriptively correlated with bacterial genomes. Hospital-wide surveillance of PCR-Kp was initiated in December-2014, after the first detection of a K. pneumoniae phenotype initially classified as PDR, recovered from close spatiotemporal cases of a sentinel hospital in Rio de Janeiro. Whole-genome sequencing of clinical PCR-Kp was performed to investigate similarities and dissimilarities in phylogeny, resistance and virulence genes, plasmid structures and genetic polymorphisms. A target phenotypic profile was detected in 10% (12/117) of the tested K. pneumoniae complex bacteria recovered from patients (8.5%, 8/94) who had epidemiological links and were involved in intractable infections and death, with combined therapeutic drugs failing to meet synergy. Two resistant bacterial clades belong to the same transmission cluster (ST437) or might have different sources (ST11). The severity of infection was likely related to patients' comorbidities, lack of antimicrobial therapy and predicted bacterial genes related to high resistance, survival, and proliferation. This report contributes to the actual knowledge about the natural history of PCR-Kp infection, while reporting from a time when there were no licensed drugs in the world to treat some of these infections. More studies comparing clinical findings with bacterial genetic markers during clonal spread are needed. [ABSTRACT FROM AUTHOR]

Splenic artery pseudoaneurysm is an extremely rare entity, although it is the most frequent location of visceral pseudoaneurysms. Trauma or previous pancreatitis (where the proteolytic pancreatic enzymes lead to the formation of pseudoaneurysm, as a result of enzymatic injury to the splenic artery wall) (Amico and Alves in Pancreatology 14: 144-145, 2014) is the most frequent causes. A high degree of suspicion is required for the accurate diagnosis. The authors present a case of splenic artery pseudoaneurysm in a middle-aged man who came to the emergency department with several days of abdominal pain. [ABSTRACT FROM AUTHOR]

Fasciola hepatica is an endemic trematode that affects millions of people worldwide. The human being can be an accidental host through consumption of contaminated food or water. The authors present a case of hepatic fascioliasis in a 69-year-old Portuguese woman who recently traveled from Egypt, Brazil, and India. [ABSTRACT FROM AUTHOR]

Hansen's Disease is an infectious disease with a slow evolution that is endemic in underdeveloped or developing countries such as Brazil. The WHO treats the disease as a problem of primary care and develops specific actions intended to eradication in several countries. The research seeks to understand the difference in the epidemiological profile of Hansen's Disease in the years 2001 to 2005 and 2014 to 2018 through the application of spatial analysis of new cases diagnosed in the urban area of Mossoró city, Rio Grande do Norte State. The methodology used was based on the analysis of specialized literature, analysis of data from SINAN and the geoprocessing of information that could be the object of geospatialization. The results demonstrate, based on the indicators applied, that the disease is in retraction in the municipality of Mossoró, but it continues being a challenge for health management, given that the classification, in terms of incidence coefficient, is that of a hyperendemic municipality, having specific areas where there is spatial prevalence of cases and a tendency to spread to more peripheral neighborhoods. [ABSTRACT FROM AUTHOR]