Localization of acute pyelonephritis in pyrexia of unknown origin using FDG PET/CT

نویسندگان

چکیده مقاله:

Objective(s): Acute pyelonephritis presents with high-grade fever, dysuria, flank pain, leukocytosis, and microscopic hematuria. Urine culture aids in the diagnosis of this infection. It can be complicated or uncomplicated. Complicated pyelonephritis includes uncontrolled diabetes, transplant, pregnancy, acute or chronic renal failure, structural abnormality of the urinary tract, immunocompromised state, and hospital-acquired infections. Gram-negative bacteria commonly involved are Escherichia, Klebsiella, Proteus, and Enterobacter. TheFDG PET/CT helps detect occult causes of fever, such as skeletal tuberculosis, thyroiditis, and lymphoma, when other investigations are inconclusive. We present three cases of pyrexia of unknown origin (PUO) in whom FDG PET/CT helped localize the focus of infection in the kidneys. Methods: The18F-FDG PET/CT was performed on all three cases and images were acquired using the Biograph Horizon PET/CT system. Results: A cortical-based focus of FDG uptake was localized in the kidneys. The focus of abnormality was persistent following diuretic administration at 1-hour delayed regional image. Two cases had supportive evidence of pyelonephritis on DMSA scan. One case also had frank pus drained after DJ stenting of the affected side. All of them responded to treatment. Conclusion: Physiologic excretion of FDG in the urinary tract may interfere with the detection of the focus of infection in the kidneys on FDG PET/CT. However, occult infection in the kidneys may be detected with adequate precautions, such as the use of diuretics and delayed imaging, as illustrated in this case report. Routine investigations were noncontributory in all three cases presenting with PUO. However, FDG PET provided a diagnostic clue for pyelonephritis.

برای دانلود باید عضویت طلایی داشته باشید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

FDG PET/CT in evaluation of pyrexia of unknown origin.

Pyrexia of unknown origin (PUO) is defined as fever above 38.5°C lasting for 3 weeks, of which at least 1 week has been spent in thorough investigation without a conclusive cause. Tuberculosis remains an important cause of PUO, particularly with the rising incidence of human immunodeficiency virus infection. It may strike virtually any organ in the body and can even mimic metastases especially ...

متن کامل

Pyrexia of Unknown Origin

One of the most challenging problem a physician used to face in day to day practice is the evaluation of patients with prolonged pyrexia—a truly significant test of his clinical skills. Causes of PUO vary according to geographical area, health care setup, investigations facilities, and physicians’ attitude. Because of socioeconomic and other factors, infectious diseases are still very common in...

متن کامل

Mediastinitis presenting as pyrexia of unknown origin.

A 55 year old female was admitted as a case of pyrexia of unknown origin (PUO) of 2 months duration. She had developed throat ache, progressive dysphagia for both solids and liquids, dry cough and retrosternal pain for one week. Examination revealed fever, tachycardia, tachypnoea and a soft tissue warm tender, erythematous, non-fluctuant swelling in lower anterior neck with chest findings sugge...

متن کامل

Pyrexia of unknown origin: Kikuchi-Fujimoto disease.

A case of Kikuchi-Fujimoto disease is presented in the context of pyrexia of unknown origin. Although no specific etiology has been identified, several reported cases are associated with a variety of viruses, toxoplasma, or systemic lupus erythematosus. We present a case and discuss the implications for management.

متن کامل

منابع من

با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

ذخیره در منابع من قبلا به منابع من ذحیره شده

{@ msg_add @}


عنوان ژورنال

دوره 8  شماره 1

صفحات  79- 83

تاریخ انتشار 2020-01-01

با دنبال کردن یک ژورنال هنگامی که شماره جدید این ژورنال منتشر می شود به شما از طریق ایمیل اطلاع داده می شود.

میزبانی شده توسط پلتفرم ابری doprax.com

copyright © 2015-2023