The importance of serological assays in diagnosing acute pulmonary histoplasmosis

Histoplasmosis is a systemic mycosis caused by inhalation of Histoplasma capsulatum microconidia. The disease does not normally affect immunocompetent individuals after a single, transient inhalation exposure. However, longer exposure may cause chronic or disseminated acute pulmonary infection. Herein, we report the case of a 24-year-old immunocompetent patient, who presented fever, cough and dyspnea for one month. The chest radiography revealed interstitial infiltrate and diffuse micronodules. The patient reported having had close and prolonged contact with bats. Diagnosis was confirmed by positive double immunodifusion and immunoblotting assays. She was treated with ketoconazole (400 mg) and there was complete resolution of the disease.

Use of immunoblotting assay improves the sensitivity of paracoccidioidomycosis diagnosis

The purpose of this work was to evaluate two serological assays: double immunodiffusion (DI) and immunoblotting (IB) in immunodiagnosis of paracoccidioidomycosis (PCM). We evaluated by IB assay 23 sera samples from patients with clinical confirmation of PCM, all of them with negative DI results against culture filtrate from Paracoccidioides brasiliensis isolate 113. For IB, as well as for comparative DI assay, we employed soluble components of the cell wall outer surface (SCCWOS) from P. brasiliensis isolate 113 cultivated at 36°C in Fava-Neto's agar medium for 5 and 10 days. Among the 20 sera samples analyzed by DI, 13 (65 percent) were negative and 7 (35 percent) were positive against SCCWOS obtained on the 5th and 10th days. By IB assay, 95.4 percent and 100 percent of sera reacted against gp43 and gp70 present in SCCWOS from the 5th day and 95.6 percent recognized these fractions when evaluated against SCCWOS from the 10th day. Our results demonstrated that the use of an immunoenzymatic assay significantly improves the sensitivity of PCM immunodiagnosis and also suggests that at least two serological tests for antibody detection should be adopted in cases of questionable diagnosis.

Influencia do controle glicemico na hiperlipemia de mulheres diabeticas (tipo II) / Influency of hyperlipidemia in diabetics women (type II)

Estudamos os niveis sericos de glicose, HbA1c, alfa2 e beta globulinas em 46 mulheres entre 51 e 70 anos, para observar sua correlacao com o perfil lipidico no diabetes mellitus nao insulino dependente, para tentar estabelecer uma associacao entre a hiperlipemia e o controle glicemico inadequado. Dentre os parametros estudados o colesterol total, o HDL-colesterol e os triglicerides se correlacionaram positivamente com a glicemia e as proteinas glicadas nas diabeticas tipo II, o que pode ressaltar o efeito da hiperglicemia no metabolismo lipidico. No nosso estudo houve uma diminuicao de 20 por cento nos niveis de HDL-Col. nas mulheres diabeticas quando comparadas com o grupo controle nao diabetico. Este decrescimo se acentua com a obesidade. Estas diabeticas apresentaram um nivel pouco alterado de colesterol total, com media geral de 243 mg/dl com um risco maior para os problemas cardiovasculares. Observamos tambem um aumento de 2 vezes a media dos niveis de triglicerides, quando comparados com a populacao controle de mesmo sexo, idade e peso semelhantes