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PET-CT scan in patients with infective endocarditis for early detection of embolisation and metastatic infection

Abstract number: 1733_971

Hill E., D'Hondt E., Crevits J.H.G., Vanderschueren S., Herregods M-C., Herijgers P., Dymarkowski S., Mortelmans L., Peetermans W.E.

Objectives: In infective endocarditis (IE), the risk for embolisation and metastatic infection is the highest during the first 2 weeks after initiation of therapy. Before surgical intervention, it is important to exclude metastatic foci to reduce the risk of relapse bacteraemia in the presence of a prosthetic valve.

Methods: From March to August 2006, 13 patients (14 episodes) with definite IE according to modified Duke criteria were included. PET-CT scan was performed within 2 weeks after diagnosis of IE. This study investigated whether PET-CT should be recommended in all patients with IE to detect early peripheral embolisation and metastatic infection.

Results: The mean age was 62 years and 54% were males. The causative microorganisms were Staphylococcus aureus in 3 episodes, streptococci in 5, enterococci in 4 and others in 2. Nine episodes involved native valves and 5 prosthetic. In 3/14 episodes (21%) PET-CT was positive for peripheral embolisation without clinical suspicion. In 5/14 episodes (36%), PET-CT was positive for metastatic infection, whereof in 1 episode without clinical suspicion. In 7/14 episodes with clinical suspicion of metastatic infection, it was not confirmed by PET-CT in 3 episodes. In 1 patient with clinical suspicion of metastatic infection and a positive PET-CT (spondylodiscitis), it was not confirmed on MRI.

Overall, PET-CT was positive in 4/14 episodes (29%) without previous clinical suspicion.

Conclusion: Overall, 50% of IE episodes had a positive PET-CT result for peripheral embolisation and/or metastatic infection. Early detection of peripheral embolisation and/or metastatic infection by PET-CT in episodes without clinical suspicion occurred in nearly one third.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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