We report the case of a 10 year old girl, born and raised in the city of Iquitos in Peru who presented with headache, fever, chills, musculoskeletal pain, mild epigastric pain, epistaxis and hematemesis. On physical examination, the patient was afebrile and in good general condition. Serological tests confirmed infection of dengue and leptospirosis. The patient received intravenous hydration with sodium chloride 0.9% and penicillin G sodium, achieving a favorable clinical course such that she was discharged a few days after admission to the hospital. Although these diseases are common in the Peruvian Amazon, the simultaneous presence of both in the pediatric population is little documented; therefore, a good clinical history and laboratory tests are important for diagnosis and treatment.

We present the case of a 60 year old patient suffering pain and the sensation of a foreign body in the anal region associated with traces of blood in stools. Digital rectal exam (DRE) revealed a hardened lesion located on the wall of the anal canal. Colonoscopy revealed a raised proliferating lesion with a blackish color which was about 2 inches in diameter. This was compatible with an anal canal malignancy. We proceeded to a biopsy and immunohistochemistry study which tested positive for S-100 and negative for HMB-45. A multislice helical chest, abdominal and pelvic CAT scan ruled out metastatic tumors and lymphadenopathy. The patient underwent local transanal excision of the partially pigmented tumor. Post- surgical histopathological results confi rmed the diagnosis of malignant anal amelanotic melanoma positive for S-100. The sample tested weakly positive for Melan-A and positive for ...