Pacemaker-related infection detected by (18)F-fluorodeoxyglucose positron emission tomography-computed tomography
Giselle de Lima Peixoto1, Rinaldo Focaccia Siciliano1, Raphael Abegão Camargo1
1Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Enéas de Caravalho Aguiar, 44, CEP 05403-000, São Paulo, SP, Brazil.
Abstract:
Lead endocarditis (LE) is one of the most feared complications and remains a challenging diagnosis in cardiology due to the possibility of an obscure clinical course and symptoms, leading to a delayed diagnosis, or even no diagnosis. (18)F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) appears to be a valuable imaging technique and has been shown to have advantages in the diagnosis of patients with fever of unknown origin. We present the case of a 52-year-old man with a 3-year history of intermittent fever, chills, anemia, and weight loss (13kg). He was submitted to an extensive investigation to clarify his symptoms and all results were negative. LE was finally diagnosed by FDG PET/CT. This examination could become a useful noninvasive method for the detection of LE at an earlier stage, thus avoiding repeated tests and reducing the length of hospital stay.
Insights
Lead endocarditis (LE) is difficult to diagnose, often presenting with vague symptoms. (18)F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) successfully diagnosed LE in a patient with prolonged unexplained symptoms, offering a new noninvasive detection method.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Lead endocarditis (LE) is a severe complication of cardiac device implantation.
- Diagnosis of LE is challenging due to nonspecific symptoms and obscure clinical presentation.
- Fever of unknown origin (FUO) often requires advanced diagnostic imaging.
Observation:
- A 52-year-old male presented with a 3-year history of intermittent fever, chills, anemia, and weight loss.
- Extensive prior investigations for his symptoms yielded negative results.
- FDG PET/CT was utilized for further diagnostic evaluation.
Findings:
- FDG PET/CT identified lead endocarditis (LE) in a patient with a long history of unexplained symptoms.
- The imaging technique proved effective in diagnosing a condition often missed by conventional methods.
- This case highlights the utility of FDG PET/CT in complex diagnostic scenarios.
Implications:
- FDG PET/CT may serve as a valuable noninvasive tool for early detection of lead endocarditis (LE).
- Implementing FDG PET/CT could reduce the need for repeated diagnostic tests and shorten hospital stays.
- This imaging modality offers potential to improve patient outcomes by enabling timely diagnosis and treatment of LE.
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