TY - JOUR
T1 - The role of FDG-PET/CT imaging in early detection of extra-cardiac complications of infective endocarditis
AU - Orvin, K.
AU - Goldberg, E.
AU - Bernstine, H.
AU - Groshar, D.
AU - Sagie, A.
AU - Kornowski, R.
AU - Bishara, J.
N1 - Publisher Copyright:
© 2014 European Society of Clinical Microbiology and Infectious Diseases.
PY - 2015
Y1 - 2015
N2 - The exact incidence of extra-cardiac complications (ECC) in patients with infective endocarditis (IE) is unknown but presumed to be high. These patients, although mostly asymptomatic, may require a more aggressive therapeutic approach. 18fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used for the diagnosis of infections, but its role in the early diagnosis of IE complications is still unclear. This study aimed to evaluate the role of FDG-PET/CT in the early diagnosis of ECC in IE and its implications for medical management. We prospectively studied 40 consecutive patients with a confirmed diagnosis of IE (according to the modified Duke criteria) who underwent a whole body FDG-PET/CT study within 14 days from diagnosis. The FDG-PET/CT demonstrated ECC in 17 (42.5%) patients, while 8 (38.1%) of them were asymptomatic. The most frequent embolic sites were musculoskeletal and splenic. Owing to the FDG-PET/CT findings, treatment planning was modified in 14 (35%) patients. This included antibiotic treatment prolongation (27.5%), referral to surgical procedures (15%) and, most substantially, prevention of unnecessary device extraction (17.7%). According to our experiences, FDG-PET/CT imaging was useful in the detection of embolic and metastatic infections in IE. This clinical information had a significant diagnostic and therapeutic impact in managing IE disease.
AB - The exact incidence of extra-cardiac complications (ECC) in patients with infective endocarditis (IE) is unknown but presumed to be high. These patients, although mostly asymptomatic, may require a more aggressive therapeutic approach. 18fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used for the diagnosis of infections, but its role in the early diagnosis of IE complications is still unclear. This study aimed to evaluate the role of FDG-PET/CT in the early diagnosis of ECC in IE and its implications for medical management. We prospectively studied 40 consecutive patients with a confirmed diagnosis of IE (according to the modified Duke criteria) who underwent a whole body FDG-PET/CT study within 14 days from diagnosis. The FDG-PET/CT demonstrated ECC in 17 (42.5%) patients, while 8 (38.1%) of them were asymptomatic. The most frequent embolic sites were musculoskeletal and splenic. Owing to the FDG-PET/CT findings, treatment planning was modified in 14 (35%) patients. This included antibiotic treatment prolongation (27.5%), referral to surgical procedures (15%) and, most substantially, prevention of unnecessary device extraction (17.7%). According to our experiences, FDG-PET/CT imaging was useful in the detection of embolic and metastatic infections in IE. This clinical information had a significant diagnostic and therapeutic impact in managing IE disease.
KW - Complications
KW - Embolic events
KW - Endocarditis
KW - Extra-cardiac
KW - fluorodeoxyglucose-positron emission tomography/computed tomography
UR - http://www.scopus.com/inward/record.url?scp=84926379787&partnerID=8YFLogxK
U2 - 10.1016/j.cmi.2014.08.012
DO - 10.1016/j.cmi.2014.08.012
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C2 - 25636930
AN - SCOPUS:84926379787
SN - 1198-743X
VL - 21
SP - 69
EP - 76
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 1
ER -