[Impact of days elapsed from the onset of symptoms to hospitalization in COVID-19 in-hospital mortality: Time matters]. / Impacto de los días transcurridos desde el inicio de los síntomas hasta la hospitalización en la mortalidad hospitalaria por COVID-19: el tiempo importa.

Background: COVID-19 shows different clinical and pathophysiological stages over time. Theeffect of days elapsed from the onset of symptoms (DEOS) to hospitalization on COVID-19prognostic factors remains uncertain. We analyzed the impact on mortality of DEOS to hospital-ization and how other independent prognostic factors perform when taking this time elapsedinto account. Methods: This retrospective, nationwide cohort study, included patients with confirmed COVID-19 from February 20th and May 6th, 2020. The data was collected in a standardized online datacapture registry. Univariate and multivariate COX-regression were performed in the generalcohort and the final multivariate model was subjected to a sensitivity analysis in an earlypresenting (EP; < 5 DEOS) and late presenting (LP; ≥5 DEOS) group. Results: 7915 COVID-19 patients were included in the analysis, 2324 in the EP and 5591 in theLP group. DEOS to hospitalization was an independent prognostic factor of in-hospital mortalityin the multivariate Cox regression model along with other 9 variables. Each DEOS incrementaccounted for a 4.3% mortality risk reduction (HR 0.957; 95% CI 0.93---0.98). Regarding variationsin other mortality predictors in the sensitivity analysis, the Charlson Comorbidity Index onlyremained significant in the EP group while D-dimer only remained significant in the LP group. Conclusion: When caring for COVID-19 patients, DEOS to hospitalization should be consideredas their need for early hospitalization confers a higher risk of mortality. Different prognosticfactors vary over time and should be studied within a fixed timeframe of the disease.

Impact of days elapsed from the onset of symptoms to hospitalization in COVID-19 in-hospital mortality: time matters.

BACKGROUND: COVID-19 shows different clinical and pathophysiological stages over time. The effect of days elapsed from the onset of symptoms (DEOS) to hospitalization on COVID-19 prognostic factors remains uncertain. We analyzed the impact on mortality of DEOS to hospitalization and how other independent prognostic factors perform when taking this time elapsed into account. METHODS: This retrospective, nationwide cohort study, included patients with confirmed COVID-19 from February 20th and May 6th, 2020. The data was collected in a standardized online data capture registry. Univariate and multivariate COX-regression were performed in the general cohort and the final multivariate model was subjected to a sensitivity analysis in an early presenting (EP; <5 DEOS) and late presenting (LP; ≥5 DEOS) group. RESULTS: 7915 COVID-19 patients were included in the analysis, 2324 in the EP and 5591 in the LP group. DEOS to hospitalization was an independent prognostic factor of in-hospital mortality in the multivariate Cox regression model along with other 9 variables. Each DEOS increment accounted for a 4.3% mortality risk reduction (HR 0.957; 95% CI 0.93-0.98). Regarding variations in other mortality predictors in the sensitivity analysis, the Charlson Comorbidity Index only remained significant in the EP group while D-dimer only remained significant in the LP group. CONCLUSION: When caring for COVID-19 patients, DEOS to hospitalization should be considered as their need for early hospitalization confers a higher risk of mortality. Different prognostic factors vary over time and should be studied within a fixed timeframe of the disease.

Estudio descriptivo de la amiloidosis por transtiretina en un hospital de tercer nivel sin unidad de referencia / A descriptive study of transthyretin amyloidosis in a tertiary hospital without a referral unit

Antecedentes y objetivo: La amiloidosis por transtiretina (ATTR) es una enfermedad rara que forma parte de las amiloidosis sistémicas, y es una enfermedad amenazante para la vida. Puede afectar a todos los órganos y sistemas, siendo la más frecuente la afectación neurológica y cardíaca. El objetivo de este estudio es detectar posibles casos de ATTR y realizar un estudio descriptivo de los mismos. Material y métodos: Estudio descriptivo unicéntrico realizado en un hospital de tercer nivel en el que se incluyen pacientes con sospecha de ATTR entre septiembre de 2016 y enero de 2020. Resultados: Se detectan 190 pacientes sospechosos de ATTR. En el estudio se incluyen 100 de ellos, así como 10 familiares de pacientes en los que se detecta ATTR en su variante genética. En total, se detecta ATTR variante genética en 7 individuos (3 con mutación presintomática de la enfermedad), 16 pacientes con ATTR asociada a la edad y 31 individuos con amiloidosis cardíaca no filiada con las pruebas realizadas, lo que confirma la presencia de esta enfermedad en áreas no endémicas. Conclusiones: La ATTR es una enfermedad que se ha de tener en cuenta en el diagnóstico diferencial de pacientes que presentan insuficiencia cardíaca con FEVI preservada, principalmente si se asocia a síntomas neurológicos (AU)

Background and objective: Transthyretin amyloidosis (ATTR) is a rare disease that is part of systemic amyloidosis and is life-threatening. It can affect all organs and systems, the most frequent being neurological and cardiac involvement. This study aims to detect possible ATTR cases and carry out a descriptive study of them. Material and methods: Descriptive single-centre study carried out in a tertiary hospital, which included patients with suspected ATTR between September 2016 and January 2020. Results: A total of 190 suspected ATTR patients were detected. The study includes 100 of these patients, as well as 10 relatives of patients in whom ATTR was detected in its genetic variant (ATTRv). In total, ATTRv was detected in 7 individuals (3 with a presymptomatic mutation of the disease), 16 patients with age-related ATTR and 31 individuals with unknown cardiac amyloidosis with the tests performed, which confirms the presence of this disease in non-endemic areas. Conclusions: ATTR is a disease that must be taken into account in the differential diagnosis of patients with heart failure with preserved LVEF, especially if associated with neurological symptoms (AU)

Derivación y validación de una puntuación de riesgo de ingreso en la Unidad de Cuidados Intensivos para pacientes con COVID-19 / Derivation and validation of a risk score for admission to the Intensive Care Unit in patients with COVID-19

Fundamento: Identificar y validar una escala de riesgo de ingreso en las unidades de cuidados intensivos (UCI) en pacientes hospitalizados con enfermedad por coronavirus 2019 (COVID-19). Métodos: Realizamos una regla de derivación y otra de validación para ingreso en UCI, utilizando los datos de un registro nacional de cohortes de pacientes con infección confirmada por SARS-CoV-2 ingresados entre marzo y agosto del año 2020 (n = 16.298). Analizamos variables demográficas, clínicas, radiológicas y de laboratorio disponibles en el ingreso hospitalario. Evaluamos el rendimiento de la escala de riesgo mediante estimación del área bajo la curva de característica operativa del receptor (AROC). Utilizamos los coeficientes β del modelo de regresión para elaborar una puntuación (0 a 100 puntos) asociada con ingreso en UCI. Resultados: La edad media de los pacientes fue de 67 años; 57% varones. Un total de 1.420 (8,7%) pacientes ingresaron en la UCI. Las variables independientes asociadas con el ingreso en UCI fueron: edad, disnea, índice de comorbilidad de Charlson, cociente neutrófilos-linfocitos, lactato deshidrogenasa e infiltrados difusos en la radiografía de tórax. El modelo mostró un AROC de 0,780 (IC: 0,763-0,797) en la cohorte de derivación y un AROC de 0,734 (IC: 0,708-0,761) en la cohorte de validación. Una puntuación > 75 se asoció con una probabilidad de ingreso en UCI superior a un 30%, mientras que una puntuación < 50 redujo la probabilidad de ingreso en UCI al 15%. Conclusiós: Una puntuación de predicción simple proporcionó una herramienta útil para predecir la probabilidad de ingreso en la UCI con un alto grado de precisión (AU)

Background: This work aims to identify and validate a risk scale for admission to intensive care units (ICU) in hospitalized patients with coronavirus disease 2019 (COVID-19). Methods: We created a derivation rule and a validation rule for ICU admission using data from a national registry of a cohort of patients with confirmed SARS-CoV-2 infection who were admitted between March and August 2020 (n = 16,298). We analyzed the available demographic, clinical, radiological, and laboratory variables recorded at hospital admission. We evaluated the performance of the risk score by estimating the area under the receiver operating characteristic curve (AUROC). Using the β coefficients of the regression model, we developed a score (0 to 100 points) associated with ICU admission. Results: The mean age of the patients was 67 years; 57% were men. A total of 1,420 (8.7%) patients were admitted to the ICU. The variables independently associated with ICU admission were age, dyspnea, Charlson Comorbidity Index score, neutrophil-to-lymphocyte ratio, lactate dehydrogenase levels, and presence of diffuse infiltrates on a chest X-ray. The model showed an AUROC of 0.780 (CI: 0.763-0.797) in the derivation cohort and an AUROC of 0.734 (CI: 0.708-0.761) in the validation cohort. A score of greater than 75 points was associated with a more than 30% probability of ICU admission while a score of less than 50 points reduced the likelihood of ICU admission to 15%. Conclusion: A simple prediction score was a useful tool for forecasting the probability of ICU admission with a high degree of precision (AU)

Derivation and validation of a risk score for admission to the Intensive Care Unit in patients with COVID-19.

BACKGROUND: This work aims to identify and validate a risk scale for admission to intensive care units (ICU) in hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: We created a derivation rule and a validation rule for ICU admission using data from a national registry of a cohort of patients with confirmed SARS-CoV-2 infection who were admitted between March and August 2020 (N = 16,298). We analyzed the available demographic, clinical, radiological, and laboratory variables recorded at hospital admission. We evaluated the performance of the risk score by estimating the area under the receiver operating characteristic curve (AUROC). Using the ß coefficients of the regression model, we developed a score (0-100 points) associated with ICU admission. RESULTS: The mean age of the patients was 67 years; 57% were men. A total of 1420 (8.7%) patients were admitted to the ICU. The variables independently associated with ICU admission were age, dyspnea, Charlson Comorbidity Index score, neutrophil-to-lymphocyte ratio, lactate dehydrogenase levels, and presence of diffuse infiltrates on a chest X-ray. The model showed an AUROC of 0.780 (CI: 0.763-0.797) in the derivation cohort and an AUROC of 0.734 (CI: 0.708-0.761) in the validation cohort. A score of greater than 75 points was associated with a more than 30% probability of ICU admission while a score of less than 50 points reduced the likelihood of ICU admission to 15%. CONCLUSION: A simple prediction score was a useful tool for forecasting the probability of ICU admission with a high degree of precision.

A descriptive study of transthyretin amyloidosis in a tertiary hospital without a referral unit.

BACKGROUND AND OBJECTIVE: Transthyretin amyloidosis (ATTR) is a rare disease that is part of systemic amyloidosis and is life-threatening. It can affect all organs and systems, the most frequent being neurological and cardiac involvement. This study aims to detect possible ATTR cases and carry out a descriptive study of them. MATERIAL AND METHODS: Descriptive single-centre study carried out in a tertiary hospital, which included patients with suspected ATTR between September 2016 and January 2020. RESULTS: A total of 190 suspected ATTR patients were detected. The study includes 100 of these patients, as well as 10 relatives of patients in whom ATTR was detected in its genetic variant (ATTRv). In total, ATTRv was detected in 7 individuals (3 with a presymptomatic mutation of the disease), 16 patients with age-related ATTR and 31 individuals with unknown cardiac amyloidosis with the tests performed, which confirms the presence of this disease in non-endemic areas. CONCLUSIONS: ATTR is a disease that must be taken into account in the differential diagnosis of patients with heart failure with preserved LVEF, especially if associated with neurological symptoms.

[Derivation and validation of a risk score for admission to the Intensive Care Unit in patients with COVID-19]. / Derivación y validación de una puntuación de riesgo de ingreso en la Unidad de Cuidados Intensivos para pacientes con COVID-19.

BACKGROUND: This work aims to identify and validate a risk scale for admission to intensive care units (ICU) in hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: We created a derivation rule and a validation rule for ICU admission using data from a national registry of a cohort of patients with confirmed SARS-CoV-2 infection who were admitted between March and August 2020 (n = 16,298). We analyzed the available demographic, clinical, radiological, and laboratory variables recorded at hospital admission. We evaluated the performance of the risk score by estimating the area under the receiver operating characteristic curve (AUROC). Using the ß coefficients of the regression model, we developed a score (0 to 100 points) associated with ICU admission. RESULTS: The mean age of the patients was 67 years; 57% were men. A total of 1,420 (8.7%) patients were admitted to the ICU. The variables independently associated with ICU admission were age, dyspnea, Charlson Comorbidity Index score, neutrophil-to-lymphocyte ratio, lactate dehydrogenase levels, and presence of diffuse infiltrates on a chest X-ray. The model showed an AUROC of 0.780 (CI: 0.763-0.797) in the derivation cohort and an AUROC of 0.734 (CI: 0.708-0.761) in the validation cohort. A score of greater than 75 points was associated with a more than 30% probability of ICU admission while a score of less than 50 points reduced the likelihood of ICU admission to 15%. CONCLUSION: A simple prediction score was a useful tool for forecasting the probability of ICU admission with a high degree of precision.

Apendicitis aguda y teratoma: ¿causalidad o consecuencia? / Acute appendicitis and teratoma: causality or consequence?

La enfermedad ginecológica puede cursar con gran variedad de manifestaciones clínicas. La coexistencia de teratoma y apendicitis aguda supone un porcentaje inusual de enfermedad abdominal en mujeres jóvenes, aunque no de forma exclusiva. Apenas hay revisiones o casos documentados en la literatura, por lo que se desconoce si existe causalidad entre ambas o simplemente es una coincidencia. Exponemos el caso de una paciente joven cuyo síntoma guía fue un dolor abdominal difuso con gran discordancia clinicorradiológica, que precisó intervención quirúrgica y confirmó la presencia de ambas entidades tras el estudio anatomopatológico.(AU)

Gynaecological disorders can have a wide variety of clinical manifestations.The coexistence of teratoma and acute appendicitis accounts for unusual, but not exclusive, percentage of abdominal pathology in young women. There are virtually no reviews or documented cases in the literature, so it is unknown whether there is causality between the 2or simply a coincidence.The case is presented of a young patient whose main symptom was diffuse abdominal pain with great clinical and radiological discordance. Surgical intervention was required to confirm the presence of both pathologies after the completion of the histopathology study.(AU)

Urgencias hipertensivas: descripción de características clínicas, manejo, variables asociadas a reconsulta y pronóstico a corto plazo / Hypertensive urgencies: Description of clinical characteristics, management, variables associated with re-entry and short-term prognosis

Objetivos: Describir las características de las urgencias hipertensivas atendidas en un Servicio de Urgencias, así como las variables asociadas a reconsulta precoz (< 7 días) y al mes (< 30 días). Métodos: Se realizó un estudio descriptivo, retrospectivo de todos los pacientes atendidos en el Servicio de Urgencias de un hospital de tercer nivel durante el año 2013. Posteriormente se realizó un análisis de casos-control para analizar el grupo de pacientes con reconsulta. Resultados: Se analizaron un total de 398 urgencias hipertensivas (32,4% hombres, edad media 67,8 años) lo que representó una incidencia de 3,28/1.000 visitas. Un 80,9% eran hipertensos previamente, siendo 2,23 la media de Índice de Charlson. La cefalea fue el síntoma más frecuente (49,1%), seguida del mareo/inestabilidad (29,5%) y las náuseas/vómitos (17,1%). Un 80,7% de los pacientes recibieron tratamiento farmacológico. Las tasas de eventos cardiovasculares o mortalidad al mes fueron bajas (2,26% y 0,25% respectivamente). Pese a ello, un 7,53% y un 11,31% de los pacientes reingresaron antes de 7 días o 30 días, respectivamente. Las variables asociadas a reconsulta en el análisis multivariante fueron la presión arterial sistólica elevada en la primera determinación, la hipertensión arterial previa y la presencia de palpitaciones. Conclusiones: Las urgencias hipertensivas son entidades de elevada incidencia en los Servicios de Urgencias. En nuestro estudio, los individuos con diagnóstico previo de hipertensión arterial y la presión arterial sistólica elevada en la primera determinación tienen mayor riesgo de reconsulta y serían candidatos a un seguimiento más estrecho al alta

Objectives: To describe the characteristics of hypertensive urgencies at the emergency department, as well as the variables associated with early re-admission (<7 days) and re-admission at one month (<30 days). Methods: We conducted a descriptive, retrospective study of all patients who were admitted to the emergency department of a third level hospital during 2013. Subsequently, a case-control analysis was performed to analyze the group of patients with readmission. Results: A total of 398 hypertensive urgencies were collected (32.4% men, mean age 67.75 years), which led to an incidence of 3.28/1000 visits. Eighty point nine percent had a previous history of hypertension, and the mean Charlson Index was 2.23. Headache was the most frequent symptom (49.1%), followed by dizziness/instability (29.5%) and nausea/vomiting (17.1%). Eighty point seven percent of the patients were prescribed pharmacological treatment. The rates of cardiovascular events or mortality at one month were low (2.26% and 0.25% respectively). Despite this, 7.53% and 11.31% of patients were readmitted in under 7 days or 30 days, respectively. The variables associated with readmission in the multivariate analysis were elevated systolic blood pressure in the first determination, previous hypertension and the presence of palpitations. Conclusions: Hypertensive emergencies are high-incidence conditions in the Emergency Department. In our study, patients with a prior diagnosis of hypertension and elevated systolic blood pressure at the first determination had a higher risk of re-entry and would be candidates for closer follow-up on discharge

Presentación atípica de amiloidosis por transtiretina en un área no endémica / Atypical presentation of transthyretin amyloidosis in a non-endemic area

Antecedente y objetivo: Existen 2 tipos de amiloidosis producidas por depósitos de transtiretina, el tipo salvaje (wt-ATTR) y el tipo mutante (m-ATTR), transmitido por herencia autosómica dominante con penetrancia variable, manifestándose con clínica neurológica y/o cardíaca. Describimos 3 familias afectadas por m-ATTR diagnosticadas en un área no endémica. Material y métodos: Se estudiaron 63 pacientes con alta sospecha de amiloidosis TTR. Posteriormente, el diagnóstico se realizó por amplificación mediante PCR de ADN y en los casos positivos se estudiaron a los familiares de primer grado. Resultados: Se detectaron 7 casos positivos para m-ATTR, distribuidos en 3 familias (Glu74Gln, Val142Ile en heterocigosis y Val142Ile en homocigosis) y 3 casos de variantes no patogénicas. Conclusiones: La amiloidosis hereditaria por TTR es una enfermedad rara, pero presente en áreas no endémicas, por lo que debe tenerse en cuenta en el diagnóstico diferencial de los pacientes con polineuropatía y/o insuficiencia cardiaca con fracción de eyección preservada

Background and objective: There are 2 types of amyloidosis caused by transthyretin deposits: the wild type (wt-ATTR) and the mutant type (m-ATTR), transmitted by autosomal dominant inheritance with variable penetrance, manifesting with neurological and/or cardiac symptoms. We report on 3 families affected by m-ATTR diagnosed in a nonendemic area. Material and methods: We studied 63 patients with a high suspicion of ATTR. The diagnosis was subsequently performed by magnification through polymerase chain reaction of DNA. For the positive cases, we studied the first-degree relatives. Results: We detected 7 positive cases of m-ATTR, distributed among 3 families (Glu74Gln, Val142Ile in heterozygosity and Val142Ile in homozygosity), and 3 cases of nonpathogenic variants. Conclusions: Hereditary ATTR is a rare disease but is present in nonendemic areas and should therefore be considered in the differential diagnosis of patients with polyneuropathy and/or heart failure with preserved ejection fraction

[Hypertensive urgencies: Description of clinical characteristics, management, variables associated with re-entry and short-term prognosis]. / Urgencias hipertensivas: descripción de características clínicas, manejo, variables asociadas a reconsulta y pronóstico a corto plazo.

OBJECTIVES: To describe the characteristics of hypertensive urgencies at the emergency department, as well as the variables associated with early re-admission (<7 days) and re-admission at one month (<30 days). METHODS: We conducted a descriptive, retrospective study of all patients who were admitted to the emergency department of a third level hospital during 2013. Subsequently, a case-control analysis was performed to analyze the group of patients with readmission. RESULTS: A total of 398 hypertensive urgencies were collected (32.4% men, mean age 67.75 years), which led to an incidence of 3.28/1000 visits. Eighty point nine percent had a previous history of hypertension, and the mean Charlson Index was 2.23. Headache was the most frequent symptom (49.1%), followed by dizziness/instability (29.5%) and nausea/vomiting (17.1%). Eighty point seven percent of the patients were prescribed pharmacological treatment. The rates of cardiovascular events or mortality at one month were low (2.26% and 0.25% respectively). Despite this, 7.53% and 11.31% of patients were readmitted in under 7 days or 30 days, respectively. The variables associated with readmission in the multivariate analysis were elevated systolic blood pressure in the first determination, previous hypertension and the presence of palpitations. CONCLUSIONS: Hypertensive emergencies are high-incidence conditions in the Emergency Department. In our study, patients with a prior diagnosis of hypertension and elevated systolic blood pressure at the first determination had a higher risk of re-entry and would be candidates for closer follow-up on discharge.

Atypical presentation of transthyretin amyloidosis in a non-endemic area. / Presentación atípica de amiloidosis por transtiretina en un área no endémica.

BACKGROUND AND OBJECTIVE: There are 2 types of amyloidosis caused by transthyretin deposits: the wild type (wt-ATTR) and the mutant type (m-ATTR), transmitted by autosomal dominant inheritance with variable penetrance, manifesting with neurological and/or cardiac symptoms. We report on 3 families affected by m-ATTR diagnosed in a nonendemic area. MATERIAL AND METHODS: We studied 63 patients with a high suspicion of ATTR. The diagnosis was subsequently performed by magnification through polymerase chain reaction of DNA. For the positive cases, we studied the first-degree relatives. RESULTS: We detected 7 positive cases of m-ATTR, distributed among 3 families (Glu74Gln, Val142Ile in heterozygosity and Val142Ile in homozygosity), and 3 cases of nonpathogenic variants. CONCLUSIONS: Hereditary ATTR is a rare disease but is present in nonendemic areas and should therefore be considered in the differential diagnosis of patients with polyneuropathy and/or heart failure with preserved ejection fraction.

Bronconeumonia bilateral por Rothia mucilaginos / Bilateral bronchopneumonia due to Rothia mucilaginosa

Rothia mucilaginosa (R. mucilaginosa), antiguamente denominada Stomatococcus mucilaginosus, es un coco Gram positivo capsulado, anaerobio facultativo, que forma parte de la flora orofaríngea normal y raramente se considera patógeno en pacientes inmunocompetentes, aunque puede producir, de forma poco habitual, infecciones graves como bacteriemias, endocarditis e infecciones respiratorias: neumonías, empiemas pleurales o sobreinfección de bronquiectasias. Presentamos el caso de un varón de 74 años diagnosticado de neumonía basal derecha de evolución tórpida con mala respuesta inicial a diversos antibióticos, con empeoramiento clínico y radiológico y aparición de bronconeumonia bilateral con imágenes pseudonodulares. En 3 cultivos de esputos y en broncoaspirado se aisló R. mucilaginosa en cultivo puro. Finalmente fue tratado con Linezolid con buena respuesta clínica y normalización de la radiografía de tórax, comprobando la desaparición de R. mucilaginosa en posteriores cultivos de esputos. Existen pocos casos documentados de neumonía por R. mucilaginosa por lo que consideramos de interés presentar éste (AU)

Rothia mucilaginosa (R. mucilaginosa), formerly named Stomatococcus mucilaginosus, is a facultatively anaerobic, encapsulated gram-positive coccus, which forms part of the normal oropharyngeal and is rarely considered to be a pathogen in immunocompetent patients, although it can produce, on rare occasions, serious infections like bacteremia, endocarditis and respiratory infections; such as pneumonia, pleural empyema or superinfection of bronchiectasis. We present the case of a 74-year-old male diagnosed with right basal pneumonia of torpid evolution with poor initial response to different antibiotics, with clinical and radiological worsening and the appearance of bilateral bronchopneumonia with pseudonodular images. R. mucilaginosa in pure culture was isolated in three sputum cultures and in bronchial suction. The patient was finally treated with Linezolid with good clinical response and normalisation of the thorax radiography, confirming the disappearance of R. mucilaginosa in subsequent sputum cultures. As there are few documented cases of pneumonia due to R. mucilaginosa, we believe that presenting this case will be of interest (AU)

[Bilateral bronchopneumonia due to Rothia mucilaginosa]. / Bronconeumonia bilateral por Rothia mucilaginosa.

Rothia mucilaginosa (R. mucilaginosa), formerly named Stomatococcus mucilaginosus, is a facultatively anaerobic, encapsulated gram-positive coccus, which forms part of the normal oropharyngeal and is rarely considered to be a pathogen in immunocompetent patients, although it can produce, on rare occasions, serious infections like bacteremia, endocarditis and respiratory infections; such as pneumonia, pleural empyema or superinfection of bronchiectasis. We present the case of a 74-year-old male diagnosed with right basal pneumonia of torpid evolution with a poor initial response to different antibiotics, with clinical and radiological worsening and the appearance of bilateral bronchopneumonia with pseudonodular images. R. mucilaginosa in pure culture was isolated in three sputum cultures and in bronchial suction. The patient was finally treated with Linezolid with a good clinical response and normalisation of the thorax radiography, confirming the disappearance of R. mucilaginosa in subsequent sputum cultures. As there are few documented cases of pneumonia due to R. mucilaginosa, we believe that presenting this case will be of interest.