BackgroundBrucellosis is one of the most widespread zoonoses worldwide. It can affect any organ system, particularly the gastrointestinal system, but there is no report of acute liver failure as a brucellosis complication.Case presentationWe present a case of acute liver failure secondary to brucellosis infection. A 75-year-old Hispanic man presented to a University Hospital in Chía, Colombia, with a complaint of 15 days of fatigue, weakness, decreased appetite, epigastric abdominal pain, jaundice, and 10 kg weight loss. On examination in an emergency room, abdomen palpation was normal with hepatosplenomegaly and the results of a liver function test were elevated. The diagnosis of brucellosis was confirmed by epidemiological contact and positive Rose Bengal agglutination with negative enzyme-linked immunosorbent assay immunoglobulin M for Brucella. He was then treated with doxycycline plus trimethoprim/sulfamethoxazole, with a favorable clinical outcome.ConclusionsThe clinical presentation of brucellosis can be very imprecise because it can affect any organ system; however, there is no report of acute liver failure as a brucellosis complication. This is the first reported case in the Colombian literature of acute liver failure due to brucellosis. We found this case to be of interest because it could be taken into account for diagnosis in future appearances and we described adequate treatment and actions to be taken at presentation.

Background: Varicose pubic collateral veins are a rare phenomenon secondary to obstruction of the common femoral vein, left external iliac, or common iliac vein. This article aims to describe the clinical case of a 75-year-old female patient who presented with varicose collateral suprapubic veins. Case report: A 75-year-old female patient from a rural area in Colombia presented to the emergency department complaining of a 4-day history of edema, erythema, and pain in the suprapubic region. The patient presented with large varicose veins in the suprapubic region with erythema, warmth, and pain on palpation. A computer tomography scan of the abdomen and pelvis showed suprapubic varicose veins and contrasted in venous phase ruled out iliac vein obstruction. To rule out paraneoplastic syndrome, tumor markers, a transvaginal ultrasound, esophagogastroduodenoscopy and rectosigmoidoscopy were obtained and found to be negative. Anticoagulation with warfarin 5 mg daily and bridge therapy with enoxaparin was initiated. Conclusion: We presented the case of a patient with varicose collateral suprapubic veins of unknown origin, who received anticoagulation with warfarin and analgesic management with subsequent resolution of symptoms.

RESUMEN La anorexia nerviosa es un trastorno mental grave que afecta principalmente a mujeres jóvenes, con pobre pronóstico y una elevada mortalidad, la cual llega hasta el 25%. Dentro de las complicaciones médicas más mencionadas en la literatura se encuentran las cardiovasculares, endocrinas y metabólicas, inmunológicas y hematológicas. Las complicaciones pulmonares son escasas y hay muy poca evidencia escrita. En el presente artículo se describe un caso de bullas pulmonares y neumotórax a tensión en una paciente con anorexia nerviosa y se hace una breve discusión sobre la posible fisiopatología al compararla con los pocos casos similares publicados. PALABRAS CLAVE