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一举两得:[F]氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描成像显示的脓毒性肌肉栓塞和中心静脉导管感染

One Fell Swoop: Septic Muscle Embolism and Central Venous Catheter Infection Imaged with [F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography.

作者信息

Filippi Luca, Lacanfora Annamaria, Garaci Francesco

机构信息

Nuclear Medicine Unit, Department of Oncohaematology, Fondazione PTV, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy.

Department of Diagnostic Imaging, Molecular Imaging, University Hospital Tor Vergata, 00173 Rome, Italy.

出版信息

Diagnostics (Basel). 2024 Jan 14;14(2):180. doi: 10.3390/diagnostics14020180.

Abstract

We describe the case of a 43-year-old female with hereditary hemochromatosis, previously without cardiac issues, who presented with a severe fever (>40 to 41 °C) to our hospital. Initial assessments, including transthoracic echocardiography, showed no typical signs of infective endocarditis. A contrast-enhanced CT scan revealed a hypodense area in the right subscapular muscle, alongside pleural thicknesses. Due to the critical condition, a central venous catheter (CVC) was implanted for immediate intravenous treatment. Subsequent blood cultures, positive for , and transesophageal echocardiography led to a diagnosis of multivalvular infective endocarditis (MIE). Subsequently, the patient underwent positron emission tomography/computed tomography (PET/CT) with [F]Fluorodeoxyglucose ([F]FDG), which detected increased tracer incorporation in the muscle lesion, CVC, and pleural thicknesses. The final diagnosis was CVC infection and septic embolism to the subscapular muscle in a patient with pleuritis. This case showcases the critical role of [F]FDG PET/CT as whole-body imaging modality in diagnosing and managing complex infective cases.

摘要

我们描述了一名43岁患有遗传性血色素沉着症的女性病例,该患者之前无心脏问题,因高热(>40至41°C)前来我院就诊。包括经胸超声心动图在内的初步评估未显示感染性心内膜炎的典型体征。增强CT扫描显示右肩胛下肌有低密度区,同时伴有胸膜增厚。由于病情危急,植入了中心静脉导管(CVC)以便立即进行静脉治疗。随后的血培养结果为阳性,经食管超声心动图检查确诊为多瓣膜感染性心内膜炎(MIE)。随后,患者接受了用[F]氟脱氧葡萄糖([F]FDG)进行的正电子发射断层扫描/计算机断层扫描(PET/CT),该检查发现肌肉病变、CVC和胸膜增厚处有示踪剂摄取增加。最终诊断为一名患有胸膜炎的患者发生了CVC感染及肩胛下肌的脓毒性栓塞。该病例展示了[F]FDG PET/CT作为全身成像模式在诊断和管理复杂感染病例中的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49f8/10814708/390d39dc31de/diagnostics-14-00180-g001.jpg

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