Park Jason, Simpson Kaitlyn, Neils Megan, Riddell James
University of Pittsburgh Medical Center, Falk Medical Building, 3601 Fifth Avenue, Pittsburgh, PA 15213-2582, USA.
Case Western Reserve University Hospital, Cleveland, OH, USA.
Ther Adv Infect Dis. 2025 May 16;12:20499361251336849. doi: 10.1177/20499361251336849. eCollection 2025 Jan-Dec.
Whole body 18F-fluorodeoxyglucose positron emission tomography/CT (WBP) may be an important tool for the management of infective endocarditis (IE) by identifying areas of occult primary or metastatic infection. However, the optimal use of this study in patients with IE is unknown.
Compare clinical characteristics and outcomes in patients who did and did not have WBP as part of their endocarditis management, and describe the impact that WBP has on the management of IE.
Retrospective cohort study.
We performed a protocolized chart review of hospitalized patients with suspected IE who were discussed by a multidisciplinary endocarditis team at a tertiary care center between June 2018 and January 2022.
Among 427 patients, there were 114 patients (26.7%) in the WBP group and 313 patients (73.3%) in the non-WBP group. The WBP group was significantly more likely to have end-stage renal disease, intracardiac prostheses, and cardiac devices, while the non-WBP group was more likely to have flail leaflet or paravalvular abscesses. There were no statistically significant differences in mortality, hospital readmission, or length of stay between the two cohorts. The WBP group was more likely to receive longer antibiotic courses and had higher rates of suppressive antibiotics following treatment courses ( < 0.001). The use of WBP directly affected management in 44.6% of those patients, especially when performed to evaluate intravascular prostheses and grafts. Changes in management included further workup, performance of a source control procedure, or a change in the antibiotic regimen.
WBP plays an important role in identifying metastatic foci of infection and directly impacting the management of patients with confirmed or suspected endocarditis. Infected intravascular prostheses were effectively identified via WBP, and as a result, these patients were prescribed longer courses of antibiotics and suppressive antibiotics.
全身18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（WBP）通过识别隐匿性原发性或转移性感染区域，可能成为感染性心内膜炎（IE）管理的重要工具。然而，这项检查在IE患者中的最佳应用尚不清楚。
比较接受和未接受WBP作为心内膜炎管理一部分的患者的临床特征和结局，并描述WBP对IE管理的影响。
回顾性队列研究。
我们对2018年6月至2022年1月在一家三级医疗中心由多学科心内膜炎团队讨论的疑似IE住院患者进行了标准化病历审查。
427例患者中，WBP组有114例（26.7%），非WBP组有313例（73.3%）。WBP组终末期肾病、心内假体和心脏装置的发生率显著更高，而非WBP组更易出现连枷瓣叶或瓣周脓肿。两组在死亡率、住院再入院率或住院时间方面无统计学显著差异。WBP组更可能接受更长疗程的抗生素治疗，且治疗疗程后使用抑制性抗生素的比例更高（<0.001）。WBP的使用直接影响了44.6%患者的管理，尤其是在用于评估血管内假体和移植物时。管理的改变包括进一步检查、进行源头控制手术或改变抗生素治疗方案。
WBP在识别感染的转移性病灶以及直接影响确诊或疑似心内膜炎患者的管理方面发挥着重要作用。通过WBP可有效识别感染的血管内假体，因此，这些患者接受了更长疗程的抗生素和抑制性抗生素治疗。
