array:24 [ "pii" => "S2387020621002722" "issn" => "23870206" "doi" => "10.1016/j.medcle.2020.04.053" "estado" => "S300" "fechaPublicacion" => "2021-07-09" "aid" => "5266" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2021;157:42" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775320303936" "issn" => "00257753" "doi" => "10.1016/j.medcli.2020.04.045" "estado" => "S300" "fechaPublicacion" => "2021-07-09" "aid" => "5266" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2021;157:42" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Tuberculosis de la pared torácica: una infrecuente localización extrapulmonar" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "42" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Chest wall tuberculosis: a rare extrapulmonary localization" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 507 "Ancho" => 750 "Tamanyo" => 57767 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Imagen de TC torácica. Se observa tumefacción de partes blandas e imagen hipodensa en cara posterolateral de hemitórax inferior izquierdo, a nivel de músculos intercostales, entre el octavo, noveno y décimo arco costal.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Antonio Rosales-Castillo, María Rosario Javier-Martínez, Miguel Ángel López-Ruz" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Antonio" "apellidos" => "Rosales-Castillo" ] 1 => array:2 [ "nombre" => "María Rosario" "apellidos" => "Javier-Martínez" ] 2 => array:2 [ "nombre" => "Miguel Ángel" "apellidos" => "López-Ruz" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020621002722" "doi" => "10.1016/j.medcle.2020.04.053" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621002722?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320303936?idApp=UINPBA00004N" "url" => "/00257753/0000015700000001/v1_202106240818/S0025775320303936/v1_202106240818/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020621002710" "issn" => "23870206" "doi" => "10.1016/j.medcle.2020.04.052" "estado" => "S300" "fechaPublicacion" => "2021-07-09" "aid" => "5261" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2021;157:43" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Abrupt EtCO<span class="elsevierStyleInf">2</span> elevation during a digestive endoscopy in a patient of a malignant tracheoesophageal fistula" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "43" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aumento brusco del EtCO<span class="elsevierStyleInf">2</span> durante la endoscopia digestiva en paciente con fístula traqueoesofágica maligna" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francisco Javier Arroyo-Fernandez, Tatiana Gómez-Sánchez, Luis Miguel Torres Morera" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Francisco Javier" "apellidos" => "Arroyo-Fernandez" ] 1 => array:2 [ "nombre" => "Tatiana" "apellidos" => "Gómez-Sánchez" ] 2 => array:2 [ "nombre" => "Luis Miguel" "apellidos" => "Torres Morera" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775320303882" "doi" => "10.1016/j.medcli.2020.04.041" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320303882?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621002710?idApp=UINPBA00004N" "url" => "/23870206/0000015700000001/v1_202107030650/S2387020621002710/v1_202107030650/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020621002680" "issn" => "23870206" "doi" => "10.1016/j.medcle.2020.03.021" "estado" => "S300" "fechaPublicacion" => "2021-07-09" "aid" => "5254" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2021;157:41" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Approach to psychosocial complexity in patients with cancer" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "41" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Abordaje de la complejidad psicosocial en pacientes con cáncer" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Montse Bacardit Guardiola, Jordi Delás Amat" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Montse" "apellidos" => "Bacardit Guardiola" ] 1 => array:2 [ "nombre" => "Jordi" "apellidos" => "Delás Amat" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S002577532030381X" "doi" => "10.1016/j.medcli.2020.03.021" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577532030381X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621002680?idApp=UINPBA00004N" "url" => "/23870206/0000015700000001/v1_202107030650/S2387020621002680/v1_202107030650/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Chest wall tuberculosis: A rare extrapulmonary localization" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "42" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Antonio Rosales-Castillo, María Rosario Javier-Martínez, Miguel Ángel López-Ruz" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Antonio" "apellidos" => "Rosales-Castillo" "email" => array:1 [ 0 => "anrocas90@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "María Rosario" "apellidos" => "Javier-Martínez" ] 2 => array:2 [ "nombre" => "Miguel Ángel" "apellidos" => "López-Ruz" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tuberculosis de la pared torácica: una infrecuente localización extrapulmonar" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 507 "Ancho" => 750 "Tamanyo" => 57767 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest CT image. Soft tissue swelling and hypodense image are observed in the posterolateral aspect of the left lower hemithorax, at the level of the intercostal muscles, between the eighth, ninth and tenth rib.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Chest wall tuberculosis is an uncommon entity in our setting, accounting for 1–5% of cases of musculoskeletal tuberculosis and less than 1% of the total.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The symptoms are usually insidious and nonspecific and behave like a chronic abscess, so it must be considered in the differential diagnosis of chest wall tumours and abscesses, especially when microbiological cultures are negative. We report the case of a woman with a chest wall abscess positive for <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> isolates.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 24-year-old woman originally from Morocco, but living in Spain for 15 years, with no medical history of interest, who presented with a lump of gradual development, over the last three months, on the lower edge of her left side together with ipsilateral pleuritic discomfort, irritating cough and unquantified weight loss, without fever. On examination, palpation of a non-painful or fluctuating semi-soft mass on the left side of the chest without associated erythema or flushing, as well as significant ocular and capillary hypopigmentation was noted. Neurologically, a transient bilateral horizontal nystagmus was observed. Blood count and biochemistry were normal except for an erythrocyte sedimentation rate (ESR) of 37 mm/h. Normal chest and rib cage x-ray. Given the persistence of the symptoms, a computed tomography (CT) scan was requested, which showed a 9 × 2 cm collection in the left chest wall (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and magnetic resonance imaging, which detected a significant enhancement of the chest wall, suggestive of an abscess.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">A CT-guided core needle biopsy was performed with drainage of purulent fluid. Samples were sent to microbiology, and amoxicillin/clavulanic acid was administered empirically. The standard bacterial culture was negative, as well as the smear microscopy and the polymerase chain reaction (PCR) for <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span>. However, in mycobacterial culture there was growth of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> without resistance to tuberculostatics.</p><p id="par0020" class="elsevierStylePara elsevierViewall">After these results, antibiotic therapy was discontinued, and quadruple therapy was established for two months. A control CT scan was performed one month after the start of treatment, which confirmed complete drainage of the abscess, as well as the absence of signs pointing to cartilage or pleural rib involvement. Four more months with dual therapy were completed.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Given the existence of ocular and capillary hypopigmentation, together with nystagmus and the development of a chest wall abscess caused by <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span>, the possibility of an immunodeficiency syndrome and underlying hypopigmentation was considered. Genetic testing for Chediak–Higashi syndrome, Hermansky–Pudlak syndrome and familial hemophagocytic lymphohistiocytosis was negative, but the genetic diagnosis of oculocutaneous albinism type 1 was confirmed.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The patient remained asymptomatic after completing treatment with good tolerance. As previously mentioned, chest wall tuberculosis accounts for a small percentage of tuberculosis. According to some series, up to 83% have a history of previous tuberculosis<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and its most common location is usually the sternum, costal curvature and costochondral junction.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Three possible mechanisms have been postulated: reactivation of latent bacilli after hematogenous spread, extension from lymphadenitis of the chest or by contiguity from the pleura or lung.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Its most common form of presentation is as a single lesion, without fluctuation or local inflammatory signs, showing nonspecific symptoms<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>: irritating cough, pleuritic discomfort, weight loss or night sweats. Laboratory findings are generally of little use and are often initially confused with a rib wall tumour or pyogenic abscess.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Regarding imaging tests, ultrasound may be useful initially, although CT is the one that best characterizes the lesion,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> also demonstrating the possibility of fistulisation or costochondral involvement.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Diagnosis is based on sampling, preferably with surgical biopsy given the low sensitivity of fine needle aspiration (FNA), and demonstration of the presence of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> in the sample. Culture is the definitive method, since both sputum smear microscopy and PCR show lower sensitivity (20% and 63%, respectively).<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Regarding treatment, most authors advocate the combination of drug and surgical treatment due to a lower recurrence rate. The duration of tuberculostatic treatment is usually six months, although in some cases it can be extended to nine or 12. The surgery allows both the drainage and the resection of the bone or cartilaginous parts involved.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rosales-Castillo A, Javier-Martínez MR, López-Ruz MÁ. Tuberculosis de la pared torácica: una infrecuente localización extrapulmonar. Med Clin (Barc). 2021;157:42.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 507 "Ancho" => 750 "Tamanyo" => 57767 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest CT image. Soft tissue swelling and hypodense image are observed in the posterolateral aspect of the left lower hemithorax, at the level of the intercostal muscles, between the eighth, ninth and tenth rib.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isolated abscess of the thoracic and abdominal wall: an exceptional form of tuberculosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Abid" 1 => "M. Ben Amar" 2 => "M. Abdenadher" 3 => "A.H. Kacem" 4 => "R. Mzali" 5 => "I.B. Mohamed" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmr.2009.11.010" "Revista" => array:6 [ "tituloSerie" => "Rev Mal Respir." "fecha" => "2010" "volumen" => "27" "paginaInicial" => "72" "paginaFinal" => "75" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20146955" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chest wall tuberculosis: report of 3 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Zidane" 1 => "O. Bakzaza" 2 => "O. Afandi" 3 => "Y. Baiz" 4 => "A. Chafik" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Pneumol Clin." "fecha" => "2015" "volumen" => "71" "paginaInicial" => "290" "paginaFinal" => "293" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chest wall tuberculosis - A clinical and imaging experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.B. Grover" 1 => "M. Jain" 2 => "S. Dumeer" 3 => "N. Sirari" 4 => "M. Bansal" 5 => "D. Badgujar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0971-3026.76051" "Revista" => array:6 [ "tituloSerie" => "Indian J Radiol Imaging." "fecha" => "2011" "volumen" => "21" "paginaInicial" => "28" "paginaFinal" => "33" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21431030" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary tubercular chest wall abscess in a young immunocompetent male" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Sharma" 1 => "R.K. Mahajan" 2 => "V.P. Myneedu" 3 => "B.B. Sharma" 4 => "N. Duggal" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Case Rep Pulmonol." "fecha" => "2014" "volumen" => "2014" "paginaInicial" => "1" "paginaFinal" => "4" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculous retropharyngeal abscess with Pott disease and tuberculous abscess of the chest wall: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.E. Hsu" 1 => "C.Y. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Medicine" "fecha" => "2019" "volumen" => "98" "paginaInicial" => "1" "paginaFinal" => "7" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015700000001/v1_202107030650/S2387020621002722/v1_202107030650/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015700000001/v1_202107030650/S2387020621002722/v1_202107030650/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621002722?idApp=UINPBA00004N" ]
Journal Information
Vol. 157. Issue 1.
Pages 42 (July 2021)
Share
Download PDF
More article options
Vol. 157. Issue 1.
Pages 42 (July 2021)
Letter to the Editor
Chest wall tuberculosis: A rare extrapulmonary localization
Tuberculosis de la pared torácica: una infrecuente localización extrapulmonar
Visits
1
Antonio Rosales-Castillo
, María Rosario Javier-Martínez, Miguel Ángel López-Ruz
Corresponding author
Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain
This item has received
Article information
These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscribe
Purchase
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail