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Published on: April 1, 2022
Arteriovenous fistula stent infection diagnosed with radiolabelled leucocyte scintigraphy
Jeong Rae Yoo1, Sang Taek Heo, Miyeon Kim
1From the 1 Division of Infectious Disease, Jeju National University School of Medicine , Jeju , Republic of Korea.
Abstract:
Infectious complications of haemodialysis in patients with arteriovenous fistula stent are rare. In addition, patients with low-grade infection are more difficult to diagnose. Here, we report the first case of low-grade infection of an arteriovenous fistula stent diagnosed using (99m)Tc-hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy. A 62-year-old man with end-stage renal disease was referred for prolonged fever. We performed (99m)Tc-HMPAO-labelled leucocyte scintigraphy following a work-up according to fever of unknown origin. A focal uptake on the left forearm compatible with the arteriovenous fistula stent insertion site was shown, and the stent was removed. (99m)Tc-HMPAO-labelled leucocyte scintigraphy could be a suitable method for assessing vascular stent infection in low-grade fever.
Insights
Diagnosing low-grade arteriovenous fistula stent infections in hemodialysis patients is challenging. Technetium (99m)Tc-hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy successfully identified a rare stent infection, aiding prompt treatment.
Area of Science:
- Nephrology
- Nuclear Medicine
- Infectious Diseases
Background:
- Arteriovenous fistula (AVF) stents are crucial for hemodialysis access.
- Infectious complications, particularly low-grade infections, pose diagnostic challenges in AVF stent patients.
Observation:
- A 62-year-old end-stage renal disease patient presented with prolonged fever of unknown origin.
- Diagnostic work-up included Technetium (99m)Tc-hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy.
Findings:
- Scintigraphy revealed focal uptake at the AVF stent site in the left forearm.
- This finding led to the diagnosis of a low-grade arteriovenous fistula stent infection.
Implications:
- Technetium (99m)Tc-HMPAO-labelled leucocyte scintigraphy is a viable method for diagnosing low-grade vascular stent infections.
- Early diagnosis and intervention can improve outcomes for hemodialysis patients with AVF stent infections.
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