Abstract Tetralogy of Fallot (TOF) consists of four cardiac changes: interventricular communication, pulmonary stenosis, aortic dextroposition and right ventricular hypertrophy. The prevalence is 0.1 per 1,000 live births. A primiparous mother with gestational age of 38 weeks came to the emergency. At the time, it was verified in her twin pregnancy that one fetus had TOF, thus a pregnancy interruption was scheduled for the following day. In the neonatal physical examination of both, localized acrocyanosis, regular heart rhythm with the presence of a heart murmur, and good peripheral perfusion were found. The echocardiogram of twin 1 revealed: patent foramen ovale; a wide perimembranous interventricular communication of misalignment, with the aorta riding the septum by 50%; hypertrophied and long infundibulum with pulmonary infundibulo-valvular stenosis, with a maximum systolic gradient of 66 mm Hg; both pulmonary arteries presented dimensions of 0.35 mm; pulmonary valve annulus: 0.56 mm; and patent ductus arteriosus measuring 0.19 mm. The echocardiogram of twin 2 showed: patent foramen ovale; a wide perimembranous interventricular communication of misalignment, with the aorta riding the septum by 50%; hypertrophied infundibulum with stenosis pulmonary infundibulo-valve, with a maximum systolic gradient of 33 mm Hg; reduced confluent pulmonary arteries; right pulmonary artery measuring 0.40 mm and left pulmonary artery measuring 0.55 mm; pulmonary valve annulus measuring 0.72 mm; a closed arterial canal, and mild aortic regurgitation. Tetralogy of Fallot is a multifaceted syndrome with a high prevalence in pediatrics. This case is the first case of congenital heart defect concordance for TOF in monozygotic twins in Brazil.

Abstract: Introduction: Varicella o chickenpox is a highly contagious disease. Varicella is spread worldwide and is caused by the varicella zoster virus. Despite the perception that it is a benign pediatric disease, complications are expected in about 2 to 5%. The neurological involvement may vary from aseptic meningitis to encephalitis. Viruses are the most common infectious agents associated with acute encephalitis, of which 22% occur due to chickenpox. Objective: To report a varicella case of a seven-year-old male patient who developed acute encephalitis. Case description: A seven-year-old patient admitted to the emergency department due to a history of vesicular-papule-crusted skin lesions on the face, trunk and limbs. Three days later, the patient evolved with prostration, altered alertness, drowsiness and vomiting. The established therapy was with intravenous acyclovir, resulting in improvement of neurological symptoms and skin lesions. Conclusions: Every patient with chickenpox should be carefully evaluated for possible complications, including the neurologicals. Where appropriate, timely detection will help to offer specific treatment to avoid further damage.

Resumen: Introducción: La varicela es una enfermedad altamente contagiosa causada por el virus varicela zóster y está difundida mundialmente. A pesar de la percepción de que se trata de una enfermedad pediátrica benigna, se esperan complicaciones en alrededor de 2 a 5%. La implicación neurológica puede variar de meningitis aséptica a encefalitis. Los virus son los agentes infecciosos más comunes asociados con la encefalitis aguda, de los cuales el 22% ocurre debido a varicela. Objetivo: Informar el caso de varicela en un paciente de siete años que desarrolló un cuadro de encefalitis aguda. Descripción del caso: Paciente admitido en urgencias por historia de lesiones de piel vesicular-pápulo-costrosas en cara, tronco y miembros. Tres días después, el paciente evolucionó con postración, alteración del estado de alerta, somnolencia y vómito. La terapia establecida fue con aciclovir endovenoso, con lo cual mejoraron los síntomas neurológicos y las lesiones de piel. Conclusiones: Todo paciente con varicela debe ser evaluado cuidadosamente en búsqueda de posibles complicaciones, incluyendo las neurológicas para que, en su caso, sea detectado a tiempo y ofrecer tratamiento específico y evitar mayor daño.