ABSTRACT
The clinical features in patients with acute Q fever are variable. We present a patient with fever, abdominal distension, pericardial effusion, and diffuse gallium uptake in the abdominal cavity, mimicking peritonitis or peritoneum carcinomatosis. Serologic surveys revealed acute infection by Coxiella burnetii. The patient responded poorly to doxycycline and improved with oral levofloxacin. During the afebrile period, gallium inflammatory scan showed resolution of previous diffuse uptake in the abdomen, and cardiac echo resolution of pericardial effusion, which was suggestive of peritoneal inflammation related to acute C. burnetii infection. Therefore, clinicians in Taiwan should be alert to the possibility of acute Q fever in patients with fever of unknown cause, especially with clinical evidence of peritoneal and/or pericardial inflammation.
Subject(s)
Abdominal Cavity/diagnostic imaging , Gallium Radioisotopes , Peritonitis/diagnostic imaging , Q Fever/diagnostic imaging , Acute Disease , Humans , Liver/physiopathology , Male , Middle Aged , Pericarditis/diagnostic imaging , Q Fever/drug therapy , Q Fever/physiopathology , Radionuclide ImagingABSTRACT
A rapid method for the determination of trace chrysene in environmental water by solid-phase microextraction (SPME) coupled with high performmnce liquid chromatography (HPLC) was developed. The experimental conditions of SPME, such as extraction time, extraction temperature, effect of ion strength, desorption time, desorption solution, desorption mode and the analytical conditions of HPLC were optimized. The optimal conditions were room temperature, 1,100 r/min of stirring rate, 30 min of extraction time, 3 min of desorption time, and methanol as the desorption solution. Methanol was used as the mobile phase on a C18 reversed phase chromatographic column. The flow rate was 1 mL/min. The detection wavelength was 266 nm on a UV-Vis detector. The linear range was from 0.013 microgram/L to 3.0 micrograms/L, the detection limit was 2.7 ng/L, and the relative standard deviation (RSD) was 5.6%. The method was used for the determination of trace chrysene in tap water, mineral water, rain water and river water. The recoveries were from 103.2% to 119.3%, the RSDs were from 4.8% to 10.2%. The method is fast, convenient, sensitive, solvent-free, and suitable for the determination of trace chrysene in environmental water.
