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Stent biliar infectado identificado por FDG PET/CT: Reporte de un caso
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.
Medicine
|February 6, 2026
Resumen
La tomografía por emisión de positrones/tomografía computarizada con F-18 fluorodesoxiglucosa (FDG PET/CT) identificó eficazmente stents biliares infectados en un paciente con fiebre recurrente. La pronta extracción del stent y los antibióticos dirigidos resolvieron la sepsis, destacando el FDG PET/CT
Área de la Ciencia:
- Medicina Nuclear
- Radiología
- Enfermedades Infecciosas
Sus antecedentes:
- Desafíos diagnósticos en la fiebre de origen desconocido, particularmente cuando la imagen convencional no es concluyente.
- Los stents biliares permanentes pueden ser una fuente de sepsis persistente.
- El papel de la tomografía por emisión de positrones/tomografía computarizada con F-18 fluorodesoxiglucosa (FDG PET/CT) en la identificación de infecciones ocultas.
Objetivo del estudio:
- Ilustrar la utilidad diagnóstica del FDG PET/CT en la detección de stents biliares infectados.
- Demostrar la efectividad del FDG PET/CT en la guía del manejo de la sepsis recurrente posterior a la intervención biliar.
Principales métodos:
- Presentación de caso de una mujer de 82 años con fiebre recurrente y antecedentes de stents biliares.
- El estudio diagnóstico incluyó FDG PET/CT, examen endoscópico y cultivos microbiológicos.
- La intervención implicó la extracción endoscópica del stent y terapia antibiótica dirigida.
Principales resultados:
- El FDG PET/CT reveló hipermetabolismo focal en las puntas del stent biliar, indicativo de infección.
- La endoscopia confirmó papilitis duodenal, formación de biopelícula y lodo en los sitios del stent.
- Los cultivos microbiológicos identificaron Escherichia coli y Klebsiella pneumoniae.
Conclusiones:
- El FDG PET/CT es una herramienta valiosa para diagnosticar stents biliares infectados en pacientes con fiebre recurrente inexplicable.
- La utilización temprana del FDG PET/CT puede prevenir procedimientos innecesarios y facilitar intervenciones oportunas y dirigidas.
- El tratamiento exitoso implicó la extracción del stent y la terapia antimicrobiana dirigida por cultivo, lo que condujo a la resolución de los síntomas.
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