Invasive Syndrome.

Unlabelled: invasive syndrome (KPIS) is a rare clinical condition characterized by primary liver abscess associated with metastatic infection. Most case reports are from Southeast Asia, with only one case described in Portugal. The Authors present the case of a 44-year-old man with a history of fever, dry cough and cervicalgia.

Bumpy road to the diagnosis of polycythaemia vera.

Polycythaemia vera (PV) is the most common myeloproliferative neoplasm, characterised by increased red cell mass that can present as an unspecified symptom or a thrombohaemorrhagic event. Its diagnosis is based on the presence of erythrocytosis, the identification of the Janus kinase 2 mutation and bone marrow aspirate or biopsy alterations. The challenge of this disease lies on the treatment approach.

[Stroke as the dramatic presentation of infectious endocarditis: the importance of the clinical history].

The authors describe a case of infective subacute endocarditis due to Streptococcus mitis in a 72 year-old woman with systemic complaints and joint symptoms, that had started 4 months before, diagnosed as a polymyalgia rheumatica, who suddenly presented with aphasia and hemiplegia. The delay in the diagnosis might be justified by the disregard of some details in the clinical history owe to the anxious/depressive personality of the patient. The devastating evolution of this case report illustrates that in patients with an inflammatory syndrome and cardiac murmur clinicians should be highly alert for the hypothesis of an infective subacute endocarditis.