Reactivation of Chagas disease in a bone marrow transplant patient: case report and review of screening and management.

We report a patient with an autologous stem cell transplant and history of residence in a Chagas disease (CD) endemic area who developed Chagas reactivation after induction for transplantation. We recommend that patients at risk for CD be screened before transplantation, and patients found to have chronic infection be monitored for reactivation post transplant.

Donor-derived Coccidioides immitis fungemia in solid organ transplant recipients.

We report disseminated coccidioidomycosis in 3 transplant recipients from a donor in an endemic area found to have unrecognized meningeal coccidioidomycosis. All 3 transplant recipients presented within 3 weeks of receipt of their organ. Only 1 organ recipient survived the acute presentation of coccidioidomycosis. Serologic testing for Coccidioides immitis infection should be considered for organ donors residing in endemic areas.

Preanalytical variables affecting the quantification of fatty acid ethyl esters in plasma and serum samples.

BACKGROUND: Fatty acid ethyl esters (FAEEs) are cytotoxic nonoxidative ethanol metabolites produced by esterification of fatty acids and ethanol. FAEEs are detectable in blood up to 24 h after ethanol consumption. The objective of this study was to assess the impact of gender, serum or plasma triglyceride concentration, time and temperature of specimen storage, type of alcoholic beverage ingested, and the rate of ethanol consumption on FAEE concentrations in plasma or serum. METHODS: For some studies, subject were recruited volunteers; in others, residual blood samples after ethanol quantification were used. FAEEs were isolated by solid-phase extraction and quantified by gas chromatography-mass spectrometry. RESULTS: For weight-adjusted amounts of ethanol intake, FAEE concentrations were twofold greater for men than women (P /=24 h. The type of alcoholic beverage and rate of consumption did not affect FAEE concentrations. CONCLUSION: These studies advance plasma and serum FAEE measurements closer to implementation as a clinical test for ethanol intake.

The hydrolysis of fatty acid ethyl esters in low-density lipoproteins by red blood cells, white blood cells and platelets.

Fatty acid ethyl esters (FAEE), esterification products of fatty acids and ethanol, have been implicated as toxic mediators of ethanol ingestion. In this study, we investigated the in vitro hydrolysis of FAEE reconstituted in low-density lipoproteins (LDL) when incubated with human blood, cell free plasma, red blood cells, white blood cells, and platelets. We also determined the metabolic fate of the fatty acid originally incorporated in the FAEE following FAEE hydrolysis. When FAEE were incubated with human red blood cells. white blood cells, or platelets, at physiologic cell counts, 80% of the FAEE were hydrolyzed at 2 h. The FAEE-derived fatty acid was predominantly found in phospholipid and free fatty acid fractions. Cell free plasma contained minimal FAEE hydrolytic activity. These studies demonstrate that FAEE are degraded to free fatty acids and ethanol by the cellular elements in the blood. The generation of free fatty acids from extensive hydrolysis of FAEE adds support to the growing concept that at least some of the toxic effects of FAEE are mediated by the free fatty acids generated upon hydrolysis of the ethyl esters.