Background: The zika virus belongs to the family flaviviridae, and is transmitted by the arthropod Aedes aegypt. Its major importance is related to the several debilitating neurological manifestations associated with it, such as transverse myelitis. Case:The authors report a case of transverse myelitis in a patient with a previous diagnosis of Zika virus infection. After the image exams and serology, the diagnosis was confirmed and treatment with prednisone was performed with an unsatisfactory clinical outcome. Conclusion:Brazil is the country of greatest concern worldwide due to the thousands of Zika cases with associated neurological complications, causing sequels and physical disabilities. However, cases worldwide have increased substantially.

Background: The congenital malformation of the posterolateral portion of the diaphragm is called the Bochdalek hernia, and was first described in 1948 by anatomy professor Bochdalek. The diagnosis in adults is extremely rare, being in the majority, an occasional finding in a chest x-ray. Case:The authors report a Bochdalek Hernia case in an adult pacient, with complaints of dyspnea and epigastralgia refractory to pharmacological treatment. The diagnosis was confirmed after a chest CT scan. Conclusion:Bochdalek hernias are extremely rare in adults, commonly diagnosed in childhood. The importance of recognition of its diagnosis is crucial, so it should be always among differential diagnoses in radiology, due to the range of complications that may affect the patients.

Background: Situs Inversus Totalis is a rare clinical condition that gives a mirror aspect to the position of the organs. It is a congenital condition and though it does not affect normal health or longevity, it may be a challenge in cases requiring surgical intervention. Case:The authors report a case of cholelithiasis in a patient with previous diagnosis of Situs Inversus Totalis. The patient presented abdominal pain, related to eating and associated with nausea and vomiting. After the image exams, it was performed the surgical procedure, without intercurrences. Conclusion:Situs Inversus Totalis is a challenge for surgical approach because of the mirrored configuration of the organs, which can lead to misdiagnosis. Using image exams and a complete evaluation of the patient helps the correct management in case of surgical procedures, and consequently influence in the prognosis.

Background: Tuberculosis is an infectious disease caused by a bacillus called Mycobacterium tuberculosis or Koch's Bacillus (BK). It is associated with various long-term lung complications, including: lung scarring (fibrosis), bronchiectasis, Chronic Pulmonary Aspergillosis, and more rarely, atelectasis. There is however very limited data in literature on the full spectrum of these complications, and relies mostly on case reports and small case series. Case: The authors report a case of atelectasis in a patient with previous diagnosis of Tuberculosis. Normal laboratory tests and imaging test presenting right lung atelectasis. Went under respiratory therapy, presented improve and is under clinical control. Conclusion: There is a huge importance of knowing the various methods to diagnose this disease and treat it well. Thus, it enables an improvement in the patient and a reduction in the spread of bacteria.

Introduction: During the course of leprosy, 10 to 50% of individuals can be surprised by reaction states, which are immune system reactions of the patient to Mycobacterium leprae. Leprosy reactions constitute the main cause of nerve damage and disability caused by leprosy.Objective: To analyze the clinical and therapeutic profile of patients with leprosy reactions registered in a Dermatology Service in the city of Belém-PA.Methods: This is a cross-seccional, descriptive study. It was investigated through analysis of medical records, 52 patients who fit the established inclusion criteria. Data were collected in July and August 2016.Results: It was found a predominance of men, from the metropolitan region. The clinical form most common of Leprosy was Borderline, and the leprosy reaction type 1. The most of reactions occurred right after the introduction of multidrug therapy,and more than a half of patients with type 1 reaction showed edema of limbs. Regarding the type 2, fever and general symptoms were the most common, present in all cases. The frequency of neural damage was evident, showing reduction of motor force level andloss of protective sensation. Conclusion:Early diagnosis and appropriate therapeutic management of reactive events is critical to the prevention of disabilities.

Background: Dohi's Reticulated Acropigmentation is a rare autosomal dominant genodermatosis with high penetrance, characterized by small, irregular, hypo and hyperpigmented macules on the dorsal surface of the distal extremities. Case:The authors report a case of Dohi's Reticulated Acropigmentation in a 61 years old female patient. The patient complained of spots on hands, feet and posteriorly face involvement since she was 7 years old.