Immunoscintigraphy with 99mTc-Besilesomab in Aid to Fusiariosis Detection in Patients with Relapsed Acute Myeloid Leukemia (AML): A Case Report and Literature Review

Abstract

The aim of this article is to emphasize the importance of nuclear medicine in fungal infection characterization through a case report. Case: patient female, with AML-M2, hospitalized with fever, dyspnea, nausea, myasthenia, abdominal pain and diarrhea. In the physical examination exacerbated lesion in abdominal wall and subcutaneous nodules in upper and lower limbs. The computed tomography of the chest evinced area of attenuation in ground-glass opacities in the middle lobe, tending to consolidation and bilateral nodular opacities with ground-glass halo which suggested an inflammatory/infectious process of fungal etiology. Immunoscintigraphy with 99m Tc-besilesomab (Scintimun ® ) identified focal infectious processes in activity, scattered over cutaneous and subcutaneous tissues, predominantly in extremities. In blood culture test, there was a growth of Fusarium sp. There is a difficulty in the diagnosis of fungal infections, both in clinical and imaging methods. There is no specific method to reaching the target. In addition, fungal diseases can be divided into focally localized or disseminated infections. There is a greater difficulty in the diagnosis of immunocompromised individuals due to the deficiency of basic defense mechanisms. Scintimun ® (scintigraphy with besilesomab) is a useful tool of nuclear medicine in the diagnosis of infectious and inflammatory diseases to allow the image of the whole-body and in vivo detection of early pathological and physiological phenomena, even before anatomical alterations occur.