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Infected plastic biliary stent identified by FDG PET/CT: A case report
Yeon-Hee Han1, Seong-Hun Kim2, Chang-Seop Lee2
1Department of Nuclear Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Cyclotron Research Center, Molecular Imaging and Therapeutic Medicine Research Center, Jeonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, Republic of Korea.
F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) effectively identified infected biliary stents in a patient with recurrent fever. Prompt stent removal and targeted antibiotics resolved the sepsis, highlighting FDG PET/CT
Area of Science:
- Nuclear Medicine
- Radiology
- Infectious Disease
Background:
- Diagnostic challenges in fever of unknown origin, particularly when conventional imaging is inconclusive.
- Indwelling biliary stents can act as a source of persistent sepsis.
- The role of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in identifying occult infections.
Purpose of the Study:
- To illustrate the diagnostic utility of FDG PET/CT in detecting infected biliary stents.
- To demonstrate the effectiveness of FDG PET/CT in guiding management for recurrent sepsis post-biliary intervention.
Main Methods:
- Case presentation of an 82-year-old woman with recurrent fever and a history of biliary stents.
- Diagnostic workup included FDG PET/CT, endoscopic examination, and microbiological cultures.
- Intervention involved endoscopic stent removal and targeted antibiotic therapy.
Main Results:
- FDG PET/CT revealed focal hypermetabolism at the biliary stent tips, indicative of infection.
- Endoscopy confirmed duodenal papillitis, biofilm formation, and sludge at the stent sites.
- Microbiological cultures identified Escherichia coli and Klebsiella pneumoniae.
Conclusions:
- FDG PET/CT is a valuable tool for diagnosing infected biliary stents in patients with unexplained recurrent fever.
- Early utilization of FDG PET/CT can prevent unnecessary procedures and facilitate timely, targeted interventions.
- Successful treatment involved stent removal and culture-directed antimicrobial therapy, leading to symptom resolution.
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