Neumonitis lúpica: presentación de un caso

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease. Pleuropulmonary manifestations occur in almost 50% of patients during the course of the disease. Of all of the manifestations, acute lupus pneumonitis (ALP) is an unusual complication, the clinical presentation of which is characterized by fever, dyspnea, pleurisy, and cough with minimal expectoration. The mainstay of treatment is systemic corticosteroids and high-dose immunosuppressants. The objective of this article is to describe an infrequent complication with high mortality in patients with systemic lupus erythematosus.El lupus eritematoso sistémico (LES) es una enfermedad autoinmune sistémica. Las manifestaciones pleuropulmonares se presentan casi en un 50% de los pacientes en el transcurso de la enfermedad. De todas las manifestaciones, la neumonitis lúpica aguda (NLA) es una complicación inusual, cuya presentación clínica se caracteriza por fiebre, disnea, pleuritis y tos con mínima expectoración. La base del tratamiento son los corticoesteroides sistémicos e inmunodepresores a dosis altas. El objetivo de este artículo es describir una complicación infrecuente y con elevada mortalidad en pacientes afectos de lupus eritematoso sistémico

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective