Detection of metabolites by frequency-pulsed electron capture gas-liquid chromatography in serum and cerebrospinal fluid of a patient with Nocardia infection

Abstract

Serum (SR) and cerebrospinal fluid (CSF) from a patient suspected of having tuberculous meningitis were submitted to our laboratory for analysis by frequency-pulsed electron capture gas-liquid chromatography (FPEC GLC). The samples were tested for the presence of carboxylic acids, alcohols, hydroxy acids, and amines by methods described previously (C. C.

Applications of cellular fatty acid analysis.

“…In most cases, derivatives of more than one class of compounds (acids, alcohols, and amines) were analyzed. Cryptococcal (30,133), enteroviral (24,30,133), herpesvirus (30), measles virus, varicella-zoster virus, Rocky Mountain spotted fever, meningococcal (24), nocardial (22), and tuberculous (21, 30, 51) meningitis have been studied. Modification of GLC resulting in increased sensitivity is central to the direct analysis of clinical specimens (20,85).…”

Rapid diagnosis of tuberculous meningitis by frequency-pulsed electron-capture gas-liquid chromatography detection of carboxylic acids in cerebrospinal fluid

“…Based on evidence presented in past reports (1)(2)(3)(4)(5)(6)(7)(8) and data in this report, FPEC-GLC may eventually be useful as an aid to the diagnosis of some other type of diseases that give a clinical picture similar to that of tuberculous meningitis.…”

“…At this time we have only detected TSA in the CSF and sera of patients positive for M. tuberculosis. In limited studies we have not detected nonbound TSA in positive cases of M. avium or Nocardia infection (5). In such cases the detection of TSA in the CSF by FPEC-GLC indicates infection with M. tuberculosis.…”

“…Frequency-pulsed electron-capture gas-liquid chromatography (FPEC-GLC) has been used to detect low femtomole quantities of tuberculostearic acid (TSA) in CSF, serum, and pleural fluid (3,4). FPEC-GLC has also been used to study carboxylic acid profiles of other acids in these fluids (5). These studies indicated that FPEC-GLC might be used to rapidly diagnose tuberculous meningitis within 3 h. The purpose of this investigation was to obtain additional information about the specificity and sensitivity of FPEC-GLC as a diagnostic test for tuberculous meningitis.…”

Nocardiosis

“…The high sensitivity of this assay appears promising, since only 6 of 12 patients with nocardiosis had positive serology by CF tests. More sophisticated techniques, using frequencypulsed electron capture gas-liquid chromatography, allowed rapid detection of metabolites of Nocardia in serum and cerebrospinal fluid in a patient with nocardiosis, 116 but these techniques are not commercially available. These newer techniques are intriguing, but additional studies are required to define their application further.…”