RESUMO
RESUMEN Introducción: la fascitis necrotizante corresponde a una infección bacteriana de los tejidos blandos, caracterizada por necrosis difusa y rápidamente progresiva del tejido celular subcutáneo y sistema músculo aponeurótico, acompañado de un acentuado compromiso séptico sistémico. Presentación del caso: se presenta el caso de un paciente de 66 años de edad, masculino, negro, con antecedentes de una neoplasia de laringe sin diagnóstico histológico, que fue recibido en el cuerpo de guardia del servicio de Otorrinolaringología del Hospital Abel Santamaría Cuadrado, por presentar un cuadro de gran toma del estado general, fiebre, disnea inspiratoria, estridor; al examen físico se encontró lesión ulcero necrótica de gran extensión en la región anterior del cuello. Se estableció el diagnóstico de una fascitis necrotizante del cuello y una neoplasia de laringe causante de un síndrome disneico laríngeo. Se procedió a realizar necrectomía y traqueostomía e ingreso del paciente. Conclusiones: la fascitis necrotizante de la región anterior del cuello a punto de partida de una neoplasia laríngea es una infección poco común, rápidamente progresiva y de difícil diagnóstico en estadío temprano.
ABSTRACT Introduction: necrotizing fasciitis corresponds to a bacterial infection of the soft tissues, characterized by diffuse necrosis and rapidly progressive infection of the cellular subcutaneous tissue and muscular aponeurotic system, accompanied by an accentuated septic systemic compromise. Case report: a 66 year old, male, black patient with a history of a laryngeal neoplasia without histological diagnosis, who came to the emergency room of the otolaryngology service at Abel Santamaria Cuadrado General Teaching Hospital. He presented an inadequate chart of general condition, fever, inspiratory dyspnea and stridor; at physical examination, an ulcer necrotic lesion of great extension was found in the anterior region of neck and a laryngeal neplasia triggering a laryngeal dyspnoeic syndrome; performing necrectomy and tracheostomy as well as the admission of patient. Conclusions: necrotizing fasciitis of the anterior region of neck from the starting point of a laryngeal neoplasia is a rare infection, having a rapidly and progressive expansion of difficult diagnosis in early stages.
RESUMO
Mycobacterium habana was isolated in Cuba in 1971. Later, was demonstrated its protection capacity in mycobacterial infection. Here we determined the level of virulence, immunogenicity and the efficacy of three different M. habana strains as attenuated live vaccines. Intratracheal infection of BALB/c mice with high dose M. habana TMC 5135 or IPK-337 strains permitted 100% survival and limited tissue damage. Mice infected with M. habana IPK-220 showed lower attenuation, so it was discarded for the vaccination experiments. Strains IPK-337 and TMC 5135 were used as subcutaneous vaccine and compared with BCG. Nude mice vaccinated with strain 5135 showed longer but non-significant survival than BCG vaccinated animals. Cell suspensions from M. habana vaccinated mice produced higher IFNγ after stimulation with mycobacterial antigens than BCG recipients. After four months of challenge with Mycobacterium tuberculosis strain H37Rv, mice vaccinated with BCG substrain Phipps or strain TMC 5135 showed total survival, while 60% survival was exhibited by animals vaccinated with M. habana IPK-337. Both M. habana strains do not prevent the infection with M. tuberculosis but avoided the progression of the experimental disease; strain TMC 5135 showed similar level of protection than BCG.