Abstract
Background
18-Fluorodeoxyglucose positron emission tomography/computerized tomography (FDG PET/CT) scanning has recently been proposed as a diagnostic tool for lead endocarditis (LE).
Objective
FDG PET/CT might be also useful to localize associated septic emboli in patients with LE.
Case presentation
We report an interesting case of a LE patient with a prosthetic aortic valve in whom a trans-esophageal echocardiogram did not show associated aortic endocarditis. FDG PET/CT revealed prosthetic aortic valve infection. A second TEE performed 2 weeks after identified aortic vegetation. A longer duration of antimicrobial therapy with serial follow-up echocardiography was initiated. There was also increased uptake in the sigmoid colon, corresponding to focal polyps resected during a colonoscopy.
Conclusion
FDG PET/CT scanning seems to be highly sensitive for prosthetic aortic valve endocarditis diagnosis. This promising diagnostic tool may be beneficial in LE patients, by identifying septic emboli and potential sites of pathogen entry.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- CIED:
-
Cardiac implantable electronic device
- FDG PET/CT:
-
18-Fluorodeoxyglucose positron emission tomography/computerized tomography
- LE:
-
Lead endocarditis
- TEE:
-
Trans-esophageal echocardiogram
- TTE:
-
Trans-thoracic echocardiogram
References
Tlili G, Amraoui S, Mesguich C, Rivière A, Bordachar P, Hindié E, et al. High performances of (18)F-fluorodeoxyglucose PET-CT in cardiac implantable device infections: A study of 40 patients. J Nucl Cardiol Off Publ Am Soc Nucl Cardiol 2015;22:787-98.
De Winter F, Vogelaers D, Gemmel F, Dierckx RA. Promising role of 18-F-fluoro-d-deoxyglucose positron emission tomography in clinical infectious diseases. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol Avr 2002;21(4):247-57.
Task Force Members, Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta J-P, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC) endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 2015;36(44):3075-128.
Ricciardi A, Sordillo P, Ceccarelli L, Maffongelli G, Calisti G, Di Pietro B, et al. 18-Fluoro-2-deoxyglucose positron emission tomography-computed tomography: An additional tool in the diagnosis of prosthetic valve endocarditis. Int J Infect Dis IJID Off Publ Int Soc Infect Dis 2014;28:219-24.
Amraoui S, Tlili G, Sohal M, Berte B, Hindié E, Ritter P, et al. Contribution of PET imaging to the diagnosis of septic embolism in patients with pacing lead endocarditis. JACC Cardiovasc Imaging 2016;9(3):283-90.
Disclosure
The authors declare that they have no competing interests.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Amraoui, S., Tlili, G., Sohal, M. et al. Early prosthetic aortic valve infection identified with the use of positron emission tomography in a patient with lead endocarditis. J. Nucl. Cardiol. 23, 1504–1507 (2016). https://doi.org/10.1007/s12350-016-0511-6
Received:
Revised:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12350-016-0511-6