Utility of 18 F‐FDG PET/CT scan to diagnose the etiology of fever of unknown origin in patients on dialysis

Chand, Kalawat Tek; Chennu, Krishna Kishore; Yadagiri, Lakshmi Amancharla; Gupta, Ranadheer Manthri; Ram, R; Vishnubotla, Siva Kumar

doi:10.1111/hdi.12471

Cited by 15 publications

(11 citation statements)

References 25 publications

(39 reference statements)

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“…In patients with FUO, FDG PET and other nuclear imaging techniques can be the differentiator in finding the source of infection. In one study on 20 patients with ESRD with FUO, FDG PET scans revealed areas of increased FDG uptake in 15 patients [12]. Of the 20 patients, 19 had a change in treatment to address the fever [12].…”

Section: Discussionmentioning

confidence: 99%

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F-18-Fluorodeoxyglucose Positron Emission Tomography/CT Effectively Identifying Source of Infection in a Patient With Multiple Dialysis Arteriovenous Fistula Access Points

Roberts¹,

Villanueva‐Meyer²,

Bezold³

et al. 2020

Cureus

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Radiologic imaging techniques, such as F-18-fluorodeoxyglucose positron emission tomography/computerized tomography (FDG PET/CT), provide diagnostic value in a variety of diseases. In cases of suspected infection, FDG PET/CT can find areas of fluorodeoxyglucose metabolism, correlating with local acute inflammation. The following case involves a man with end-stage renal disease (ESRD), who presented with symptoms of infection and positive blood cultures with high suspicion of arteriovenous fistula as the source of infection. The patient also had two central lines that could be a site of infection. Concerns for patient's persistent positive blood cultures necessitated FDG PET/CT to confirm site of infection. Confirming active infection and the source of infection guides therapeutic measures and eliminates concern for other disease etiologies common in patients with ESRD.

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Section: Discussionmentioning

confidence: 99%

“…In one study on 20 patients with ESRD with FUO, FDG PET scans revealed areas of increased FDG uptake in 15 patients [12]. Of the 20 patients, 19 had a change in treatment to address the fever [12]. Gallium 67 citrate and labeled WBC scanning are often compared to FDG PET.…”

Section: Discussionmentioning

confidence: 99%

F-18-Fluorodeoxyglucose Positron Emission Tomography/CT Effectively Identifying Source of Infection in a Patient With Multiple Dialysis Arteriovenous Fistula Access Points

Roberts¹,

Villanueva‐Meyer²,

Bezold³

et al. 2020

Cureus

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show abstract

“…PET‐CT is a dual modality imaging consisting of a PET scanner and an x‐ray CT scanner. The use of PET‐CT to identify sepsis has been described in many settings . However, to our knowledge, the diagnosis of occult infection in a non‐functioning kidney transplant with PET‐CT has not been described.…”

Section: Discussionmentioning

confidence: 99%

Identification of occult active infection using PET‐CT in a combined liver‐kidney transplant candidate

Shakarchi

Neil

Lipkin

et al. 2017

Transplant Infectious Dis

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This case describes a patient being considered for combined liver-kidney transplantation for Caroli's disease with a failed renal transplant. A chronic septic focus could not be located with standard imaging techniques, such as ultrasonography and computed tomography. This case report highlights the observation that a retained non-functioning transplant can be the cause of fever of unknown origin and PET-CT can be useful in diagnosing these challenging cases.

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“…Infections are the most common cause for fever of unknown origin (FUO) 1. Tuberculosis (TB), particularly extra pulmonary TB (EPTB) is not an uncommon cause for FUO especially in the tropical countries 2. Genitourinary TB (GUTB) is one of the common sites for EPTB, although the estimates are variable 3 4.…”

Section: Introductionmentioning

confidence: 99%

Curious case of fever of unknown origin

Bhatt

Soneja²,

Tripathi

et al. 2018

BMJ Case Rep

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A 58-year-old immunocompetent woman presented with fever and significant weight loss of 4-month duration. She had mild pallor; rest of the examination was unremarkable. Investigations revealed anaemia with raised inflammatory markers. Cultures, serologies, routine urine examination, bone marrow examination, contrast enhanced CT and two-dimensional echocardiography examination were unremarkable. An 18F-fluorodeoxyglucose positron emission tomography with CT (18F-FDG-PET/CT) scan was performed which revealed atypical heterogenous uptake in bilateral renal cortex. Subsequently, urine GeneXpert came positive for Mycobacterium tuberculosis with sensitivity to rifampicin. She responded to category 1 antitubercular therapy. The challenges in diagnosis of genitourinary tuberculosis, low sensitivity of conventional diagnostic tests and potential role of GeneXpert and 18F-FDG-PET/CT scan are discussed in this report.

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Utility of 18 F‐FDG PET/CT scan to diagnose the etiology of fever of unknown origin in patients on dialysis

Abstract: The present study is first study of 18F-FDG PET/CT scan in patients of end stage renal disease on dialysis with FUO. The study showed that the 18 F FDG PET/CT scan may present an opportunity to attain the diagnosis in end stage renal disease patients on dialysis with FUO.

Cited by 15 publications

References 25 publications

F-18-Fluorodeoxyglucose Positron Emission Tomography/CT Effectively Identifying Source of Infection in a Patient With Multiple Dialysis Arteriovenous Fistula Access Points

F-18-Fluorodeoxyglucose Positron Emission Tomography/CT Effectively Identifying Source of Infection in a Patient With Multiple Dialysis Arteriovenous Fistula Access Points

Identification of occult active infection using PET‐CT in a combined liver‐kidney transplant candidate

Curious case of fever of unknown origin

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