Ghanem-Zoubi Nesrin, Kagna Olga, Dabaja-Younis Halima, Atarieh Menas, Nasrallah Elias, Kassis Imad, Keidar Zohar, Paul Mical
Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel.
Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
Open Forum Infect Dis. 2023 Jan 2;10(1):ofac704. doi: 10.1093/ofid/ofac704. eCollection 2023 Jan.
BACKGROUND: Diagnosis of focal infection in brucellosis is important to direct optimal treatment. Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) may be helpful in this aspect. METHODS: The clinical and imaging data of all patients with brucellosis, who underwent FDG PET/CT as part of the investigation in Rambam Health Care Campus, where FDG PET/CT became the recommended imaging modality for suspected focal infection in brucellosis since 2016, were analyzed retrospectively. The detection of focal infection as well as management modification before and after FDG PET/CT were recorded. RESULTS: FDG PET/CT was performed in 30 episodes of brucellosis occurring in 27 patients: 20 primary episodes and 10 suspected relapse episodes. The mean age of the patients was 50 ± 15.07 years. Focal disease was diagnosed in 18 of 30 (60%) episodes, of which 8 (26.6%) were diagnosed for the first time by FDG PET/CT, all of whom had spinal infection, with a concomitant additional focus in 5. Overall, multifocal disease was diagnosed in 10 of 18 (55.5%) of patients with focal disease. Management modification following FDG PET/CT was recorded in 17 of 30 (56.6%) episodes, mainly by treatment extension in spinal infection and withholding treatment in patients with suspected relapse but no evidence of active disease by FDG PET/CT. CONCLUSIONS: FDG PET/CT was found to be helpful in the diagnosis of focal infection in brucellosis. Multifocal disease seems more prevalent than previously described. The clinical impact of adding FDG PET/CT to the diagnostic workup of brucellosis should be evaluated in future studies.
背景:布鲁氏菌病局灶性感染的诊断对于指导最佳治疗很重要。氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG PET/CT)在这方面可能会有所帮助。 方法:对在兰巴姆医疗保健校园接受FDG PET/CT检查的所有布鲁氏菌病患者的临床和影像数据进行回顾性分析,自2016年以来,FDG PET/CT已成为疑似布鲁氏菌病局灶性感染的推荐影像检查方法。记录FDG PET/CT前后局灶性感染的检测情况以及治疗调整情况。 结果:27例患者共进行了30次布鲁氏菌病的FDG PET/CT检查:20例初发病例和10例疑似复发病例。患者的平均年龄为50±15.07岁。30次检查中有18次(60%)诊断为局灶性疾病,其中8次(26.6%)是首次通过FDG PET/CT诊断出来的,所有这些患者均为脊柱感染,其中5例伴有其他病灶。总体而言,18例局灶性疾病患者中有10例(55.5%)被诊断为多灶性疾病。30次检查中有17次(56.6%)记录了FDG PET/CT后的治疗调整,主要是延长脊柱感染患者的治疗时间,以及对疑似复发但FDG PET/CT未显示活动性疾病证据的患者停止治疗。 结论:发现FDG PET/CT有助于布鲁氏菌病局灶性感染的诊断。多灶性疾病似乎比之前描述的更为普遍。未来的研究应评估在布鲁氏菌病诊断检查中增加FDG PET/CT的临床影响。
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