A case of skeletal tuberculosis and psoas abscess: disease activity evaluated using 18 F-fluorodeoxyglucose positron emission tomography-computed tomography

BMC Medical Imaging

Case Report

Naoki Hasegawa¹  Ken Ishii²  Kota Watanabe²  Koji Murakami³  Kota Ishioka⁴  Tomoko Betsuyaku⁴  Kazuma Yagi⁴  Kenzo Soejima⁴  Makoto Ishii⁴  Yoshifumi Kimizuka⁴ 

[1] Center for Infectious Diseases and Infection Control, School of Medicine, Keio University, Tokyo, Japan;Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan;Division of Nuclear Medicine, Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo, Japan;Division of Pulmonary Medicine, School of Medicine, Keio University, 35 Shinanomachi Shinjuku-ku, 160-8582, Tokyo, Japan;

关键词: PET-CT;    Psoas abscess;    Gravitation abscess;    Skeletal tuberculosis;    Extrapulmonary tuberculosis;   

DOI  :  10.1186/1471-2342-13-37

 received in 2013-04-23, accepted in 2013-11-08,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundPsoas abscess complicating tuberculous spondylitis is a rare morbidity in extrapulmonary tuberculosis. There are no established guidelines for evaluating the clinical response of psoas abscess. Although several studies have shown that positron emission tomography-computed tomography with 18 F-fluorodeoxyglucose can play a potential role in diagnosing multifocal tuberculosis and monitoring the clinical response of pulmonary tuberculosis, to our knowledge, this is the first report demonstrating that positron emission tomography-computed tomography is useful for evaluating local inflammation and disease activity of a tuberculous psoas abscess.Case presentationWe report a case of multifocal bone and lymph node tuberculosis with concomitant lumbar psoas abscess in a 77-year-old man, along with a literature review. An initial positron emission tomography-computed tomography scan showed intense 18 F-fluorodeoxyglucose accumulation in the sternum, ribs, vertebrae, and lymph nodes. The patient was successfully treated with antitubercular agents and computed tomography-guided drainage therapy. A follow-up positron emission tomography-computed tomography after abscess drainage and 9 months of antitubercular drug treatment revealed that the majority of lesions improved; however, protracted inflammation surrounding the psoas abscess was still observed. These results indicate that disease activity of psoas abscess can remain, even after successful drainage and antitubercular medication regime of appropriate duration.ConclusionWe have successfully followed up the extent of skeletal tuberculosis complicated with psoas abscess by positron emission tomography-computed tomography. In this patient, positron emission tomography-computed tomography is useful for evaluating the disease activity of tuberculous psoas abscess and for assessing the appropriate duration of antitubercular drug therapy in psoas abscess.

【 授权许可】

Unknown   
© Kimizuka et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.