Combined computed tomography and fluorodeoxyglucose positron emission tomography in the diagnosis of prosthetic valve endocarditis: a case series

BMC Research Notes

Pierluigi Viale¹  Stefano Fanti³  Claudio Rapezzi⁴  Maddalena Graziosi⁴  Pier Giorgio Scotton⁵  Marco Di Eusanio²  Silvia Sanfilippo³  Cristina Nanni³  Luigi Raumer¹  Rachele Bonfiglioli³  Francesco Cristini¹  Maddalena Giannella¹  Giovanni Fasulo¹  Fabio Tumietto¹  Michele Bartoletti¹ 

[1] Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico S. Orsola Malpighi, Alma Mater Studiorum Università di Bologna, Bologna, Italy;Department of Cardiovascular Surgery, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;Nuclear Medicine, Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico S. Orsola Malpighi, Alma Mater Studiorum Università di Bologna, Bologna, Italy;Cardiology, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy;Infectious Disease Unit, Treviso City Hospital, Treviso, Italy

关键词: Duke’s criteria;    Diagnosis;    Prosthetic valve endocarditis;    FDG-PET;   

Others  :  1134847
DOI  :  10.1186/1756-0500-7-32

 received in 2013-10-09, accepted in 2014-01-03,  发布年份 2014

【 摘 要 】

Background

The diagnosis of prosthetic valve endocarditis is challenging. The gold standard for prosthetic valve endocarditis diagnosis is trans-esophageal echocardiography. However, trans-esophageal echocardiography may result in negative findings or yield images difficult to differentiate from thrombus in patients with prosthetic valve endocarditis. Combined computed tomography and fluorodeoxyglucose positron emission tomography is a potentially promising diagnostic tool for several infectious conditions and it has also been employed in patients with prosthetic valve endocarditis but data are still scant.

Case presentations

We reviewed the charts of 6 patients with prosthetic aortic valves evaluated for suspicion of prosthetic valve endocarditis, at two different hospital, over a 3-year period. We found 3 patients with early-onset PVE cases and blood cultures yielding Pseudomonas aeruginosa, Staphylococcus epidermidis and Staphylococcus lugdunensis, respectively; and 3 late-onset cases in the remaining 3 patients with isolation in the blood of Streptococcus bovis, Candida albicans and P. aeruginosa, respectively. Initial trans-esophageal echocardiography was negative in all the patients, while fluorodeoxyglucose positron emission tomography showed images suspicious for prosthetic valve endocarditis. In 4 out of 6 patients valve replacement was done with histology confirming the prosthetic valve endocarditis diagnosis. After an adequate course of antibiotic therapy fluorodeoxyglucose positron emission tomography showed resolution of prosthetic valve endocarditis in all the patients.

Conclusion

Our experience confirms the potential role of fluoroseoxyglucose positron emission tomography in the diagnosis and follow-up of prosthetic valve endocarditis.

【 授权许可】

   
2014 Bartoletti et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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