Caso: varón VIH-positivo que no sigue el tratamiento pautado pero sí acude a revisiones en consulta / Case: HIV-Positive male that does not follow the patient treatment but it may go to revised consultations

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Varicella-zoster virus (VZV) infection as a possible cause of Ogilvie's syndrome in an immunocompromised host.

We describe an immunodeficient adult with Ogilvie's syndrome preceding a disseminated papulovesicular skin rash in whom varicella-zoster virus infection was demonstrated by PCR assay in cutaneous and colonic biopsy specimens. In view of the significant morbidity and mortality that this condition carries, early and accurate molecular diagnosis and timely treatment are strongly recommended.

Tratamiento ambulatorio del derrame pleural maligno: aportación de un caso / Ambulatory treatment of malignant pleural effusion: A case report

El derrame pleural maligno es una patología frecuente en los pacientes con cáncer, y por tanto en los servicios de cuidados paliativos. Esta complicación se asocia tanto a los tumores pulmonares primarios como a los metastásicos, y suele plantear problemas relevantes a la hora de tomar decisiones terapéuticas. Presentamos un caso clínico de un enfermo diagnosticado de carcinoma epidermoide de pulmón y derrame pleural secundario, en quien se realizó tratamiento domiciliario por expreso deseo del paciente. Tras valorar las distintas opciones, se decidió la colocación de un tubotunelado permanente para drenaje pleural, cuyo manejo domiciliario resultó sencillo y eficaz. El paciente mantuvo el dispositivo funcionante hasta su fallecimiento, con buen control de los síntomas. El derrame pleural maligno requiere un manejo individualizado y una adecuada gestión de las diversas modalidades terapéuticas disponibles. En determinados casos, el empleo de un tubotunelado permanente puede aportar claros beneficios terapéuticos y mejorar la calidad de vida de los enfermos (AU)

Malignant pleural effusion (MPE) is a frequent disorder in patients with cancer and thus often seen in Palliative Care Units. MPE is associated with both primary lung cancer and metastatic tumours and will be a significant complication in making decisions about patients. We report a case of a patient with squamous cell lung cancer associated with a newly diagnosed malignant pleural effusion. At the express wish of the patient on regular at-home-treatment and assessing the therapeutic options for treatment, it was decided to place permanent tunnelled pleural drainage catheter, which was easily performed by the palliative care team at home. The patient had a functionally operating pleural drainage with good control of symptoms until his death at home. MPE requires an individualised approach and a suitable management ofthe available therapeutic possibilities. In selected patients, like ours, the use of a permanent tunnelled drainage catheter can bring clear therapeutic advantages and an increase in patient quality of life (AU)