In:
European Heart Journal - Case Reports, Oxford University Press (OUP)
Abstract:
Infective endocarditis is a challenging diagnosis that usually requires cardiovascular image confirmation as part of the approach. 18F-FDG PET/CT is an imaging technique more sensible for the diagnosis of prosthetic valve endocarditis when echocardiography is inconclusive. Case Summary We present the case of a 35-year-old man who had a previous Bentall-De Bono procedure four years prior that included biological, INC-type, locally manufactured aortic valve replacement and woven Dacron tube graft implantation in the ascending aorta. He was admitted because of dyspnea, edema, fever, and syncope. A complete auriculoventricular blockade was diagnosed, requiring cardiac pacing. Also, infective endocarditis (IE) was suspected. Blood cultures showed the isolation of Bacillus licheniformis. Transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and computed tomography angiography (CTA) were inconclusive for IE. Treatment was initiated with IV antibiotic therapy, and an extensive protocol for IE, including molecular imaging modalities, was ordered. 99mTc-Ubiquicidine scintigraphy was acquired without abnormal findings. Images of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG- PET) revealed abnormally intense heterogeneous uptake in the prosthetic aortic annulus in a classic pattern. Applying the modified 2015 Duke Criteria for PET/CT, prosthetic valve endocarditis (PVE) was confirmed. Discussion Although the other imaging modalities were negative, the high clinical suspicion made it mandatory to continue the study protocol, remarking on the utility of 18F-FDG PET/CT on patients categorized as having ¨possible¨ endocarditis, as in our patient.
Type of Medium:
Online Resource
ISSN:
2514-2119
DOI:
10.1093/ehjcr/ytad425
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2023
detail.hit.zdb_id:
2948381-5
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