ABSTRACT
Un hombre de 57 años acudió a urgencias con astenia, mareo y tos con expectoración purulenta. Ingresó a cargo del Servicio de Neumología, y se objetivó en la imagen de tomografía axial computarizada un espacio aéreo grande en el lóbulo superior derecho. Esta lesión se atribuyó a un absceso pulmonar y se aisló Streptomyces albus en las muestras respiratorias. El género Streptomyces a menudo causa infecciones de la piel y tejidos blandos. Bacteriemia, neumonía y otros cuadros son raros. En nuestro caso, el paciente presentó un absceso pulmonar de gran tamaño, a pesar de los escasos síntomas descritos. La presentación del caso es atípica, dado que S. albus no suele causar abscesos pulmonares de manera aislada. (AU)
A 57-year-old man presented with asthenia, dizziness, and cough with purulent expectoration. He was admitted to the Pulmonology Unit, and a big air space in the right upper lobe was observed in computed tomography, which was characterized as a lung abscess, and Streptomyces albus was isolated. Streptomyces usually causes superficial skin and soft tissue infections. Bacteriemia, pneumonia, and other diseases are rarely seen. Our case is presented as a big lung abscess; nonetheless, our patient was paucisymptomatic. This case presentation describes the unusual phenomenon of a lung abscess caused by S. albus solely. (AU)
Subject(s)
Humans , Male , Middle Aged , Lung Abscess/diagnostic imaging , Streptomyces , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Reslizumab is an anti-interleukin 5 monoclonal antibody that has demonstrated to reduce the risk of severe exacerbations and to improve symptoms, lung function, and quality of life in randomized controlled trials that included patients with severe eosinophilic uncontrolled asthma (SEUA) and a history of severe exacerbations. OBJECTIVE: The aim of the present study was to evaluate the effectiveness of add-on reslizumab in a cohort of patients with SEUA under real-life conditions. METHODS: This was a multi-centre, retrospective, real-life study that included subjects with SEUA treated with reslizumab in 44 asthma units throughout Spain. Eligible patients were those who had received at least one dose of reslizumab as part of normal clinical practice. The primary endpoint was complete asthma control at 52 weeks, defined as absence of severe exacerbations, ACT ≥20 and no maintenance oral corticosteroids (OCS). Demographic, clinical, and functional data were collected at baseline (T0), after four to six months (T1); after 12 months (T2) and beyond 12 months of therapy (T3). RESULTS: Treatment with reslizumab achieved complete asthma control in 40% of the 208 included SEUA patients and led to a significant reduction in exacerbations (from 3.0; IQR: 2.0-4.0 at V0 to 0.0; IQR: 0.0-0.0 at V2), maintenance OCS use (from 54.8% (95% CI: 48.0-61.6 at T0 to 18.5% (95% CI: 12.5-24.5 at T2) and a meaningful improvement in symptoms in the entire treated population: ACT increased from 12.8 ± 4.5 at V0 to 20.0 ± 5.1 at V2 (p < 0.001). Most of the improvement achieved at 12 months was obtained at 4-6 months. The retention (continuation) rate of reslizumab was 75% through 2 years (95CI%: 1.9-2.1). Overall, reslizumab showed an adequate safety profile. CONCLUSION: Reslizumab is an effective therapy for SEUA with adequate safety profile in real-life conditions.
ABSTRACT
No disponible
