[Four cases of malaria in travellers. An emerging disease]. / Cuatro casos de paludismo en viajeros. Una enfermedad emergente.

Four cases of malaria in patients who had travelled to Equatorial Guinea the previous weeks and had not received prophylaxis are presented. There were three men and one woman, two natives of Equatorial Guinea who had been living in Spain for a long time and the other two Spanish. Following a 15-30 day trip in Equatorial Guinea they all presented with fever, shivering, headache and diarrhea( two cases) five to ten days after their return. Only one patient presented splenomegaly. The thick blood smear showed plasmodia in all patients and P. falciparum was identified in only two patients. All of them were treated with doxycycline and quinine sulfate with a favourable outcome. Only one of the patients needed hospitalization. Following some aspects of the epidemiology, symptoms, diagnosis and treatment of this emerging disease are presented.

[Lung adenocarcinoma feigning an interstitial lung disease in a 30-year-old man]. / Adenocarcinoma de pulmón simulando una enfermedad pulmonar intersticial en un varón de 30 años.

A case of a 30-year-old man is presented. He had a past medical history of asthma and presented with cough, shortness of breath, fever and chest pain. The chest X-ray showed cardiomegaly and a interstitial pattern. The echocardiogram revealed a severe pericardial effusion that required performing a pericardiocentesis. A CT scan showed mediastinal adenopathies and reticulonodular interstitial pattern. A bronchoscopy could not be completed because of non-tolerance. Finally a lung biopsy allowed us to reach a final diagnosis of lung adenocarcinoma. Following, some aspects of lung cancer in young people are commented, especially its incidence, histology, symptoms and a prognosis. A few aspects of the interstitial lung disease are also addressed and the differential diagnosis with lymphangitic carcinomatosis.

[Colon lymphoma as a cause of fever of unknown origin]. / Linfoma de colon como causa de fiebre de origen desconocido.

We present a case of a 49 year old man who presented with a 2 month history of fever, nausea vomiting and weight loss (10 kg). He was admitted to the Hospital with the diagnosis of fever of unknown origin. A CT scan showed a wide thickening of the colonic wall (transverse colon and hepatic flexure) suggesting a colon tumor, and a solid mass in the left liver lobe. A colonoscopy was performed showing a circumferential neoplasm and biopsies were taken. The histopathology was informed as a diffuse large B cell lymphoma. Primary colon lymphoma is a rare gastrointestinal tumor that represents less than 1% of the gastrointestinal lymphomas. Based on this case, we reviewed the most recent articles about gastrointestinal lymphomas.

[Phylephebitis due to diverticulitis]. / Pileflebitis secundaria a diverticulitis.

A case of a 52 year-old-male, with past medical history of renoureteral crisis and recurrent episodes of abdominal pain, is presented. The patient presented to the Emergency Department with abdominal pain (similar to previous episodes), fever and abnormal liver function test (marked elevation of gammaglutamyltranspeptidase and alkaline phosphatase). An abdominal ultrasound was performed showing hepatomegaly, and enlarged spleen and an echogenic material that suggested a thrombosis. A CT scan confirmed the thrombosis of the inferior mesenteric vein extending up to the splenic vein and the portal vein. It also showed a large number of diverticulum. Surgery was performed in order to rule out an acute diverticulitis. A phylephlebitis, infective suppurative thrombosis of the portal vein and its branches (inferior mesenteric vein and splenic vein) was found due to an acute diverticulitis with neither perforation nor abscess. A ligature of the inferior mesenteric vein and a Hartmann procedure with resection of the diseased colon, and end colostomy and creation of a rectal stump, were performed. A favourable outcome was obtained with antibiotics and anticoagulation. Some aspects of the aetiology, symptoms, diagnosis and treatment of this unusual complication of diverticulitis are also presented.