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Cardiac aneurysm complicated by E. coli abscess
Abstract:
An E. coli myocardial abscess developed in the region of an old aneurysmal myocardial scar. In spite of vigorous antibiotic therapy fever and positive blood cultures persisted. A combination of In-111 WBC scanning and Tc-99m RBC gated heart imaging located the infection in the aneurysmal scar. The abscess was resected and the patient survived.
Insights
A persistent E. coli myocardial abscess, resistant to antibiotics, was successfully located using combined In-111 WBC and Tc-99m RBC imaging. Surgical resection led to patient survival.
Area of Science:
- Cardiology
- Infectious Diseases
- Nuclear Medicine
Background:
- Myocardial abscesses can develop in areas of old myocardial scars.
- Persistent fever and positive blood cultures indicate treatment-resistant infection.
Observation:
- An E. coli myocardial abscess was identified in a patient with an old aneurysmal myocardial scar.
- Standard antibiotic therapy failed to resolve the infection, evidenced by persistent symptoms.
Findings:
- Combined Indium-111 white blood cell (WBC) scanning and Technetium-99m red blood cell (RBC) gated heart imaging precisely located the abscess within the aneurysmal scar.
- Surgical resection of the abscess was performed.
Implications:
- Nuclear imaging techniques are crucial for diagnosing and localizing complex myocardial abscesses.
- Successful surgical intervention can lead to favorable outcomes in patients with refractory myocardial infections.