RESUMO
Cryptococcal meningitis is a relatively common invasive fungal infection in immunocompromised patients, especially in solid organ transplant recipients. Clinical presentation typically includes fever, headache, photophobia, neck stiffness, and/or altered mental status. Unusual presentations may delay diagnosis. Therapy is challenging in renal transplant patients because of the nephrotoxicity associated with amphotericin B, the recommended treatment. We present a case of cryptococcal meningitis in a renal transplant recipient presenting as acute sinusitis with successful treatment using fluconazole as primary therapy.
Assuntos
Antifúngicos/uso terapêutico , Cryptococcus neoformans/isolamento & purificação , Fluconazol/uso terapêutico , Transplante de Rim/efeitos adversos , Meningite Criptocócica/diagnóstico , Sinusite/diagnóstico , Cryptococcus neoformans/efeitos dos fármacos , Cryptococcus neoformans/imunologia , Diagnóstico Diferencial , Feminino , Humanos , Hospedeiro Imunocomprometido , Meningite Criptocócica/tratamento farmacológico , Meningite Criptocócica/microbiologia , Pessoa de Meia-Idade , Sinusite/tratamento farmacológico , Sinusite/microbiologiaRESUMO
The triacylglycerol (TAG) profiles present in real world lipidic samples are usually quite complex and, as such, monodimensional high-performance liquid chromatographic (HPLC) techniques are inadequate when challenged with such matrices. In this respect, the complementary use of silver-ion (Ag) and non-aqueous (NA) reversed-phase (RP) HPLC can be exploited if thorough TAG separations are required. The present investigation reports the employment of a newly developed comprehensive LC (LC x LC) system, based on the different separation mechanisms of the aforementioned techniques, and applied to a rice oil sample. The approach was successful in the separation of a high number of solutes, otherwise unachievable through monodimensional LC. Furthermore, the use of atmospheric pressure chemical ionization mass spectrometry (APCI-MS), as detection system, provided a third analytical dimension boosting the identification power of the comprehensive chromatographic method.