Challenging case of chronic Q fever endocarditis: usefulness of 18F-FDG PET/CT in the diagnosis and follow-up.
Anna Hermine MarkowichLorenza RomaniLucia LeccisottiMaia De LucaPublished in: BMJ case reports (2021)
Diagnosis of infective endocarditis can be challenging for clinicians, especially when involving prosthetic valves. Recent data suggest that 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) could be a useful diagnostic tool in this setting. Here, we report a case of a patient with an aortic biological prosthesis who presented with a history of fever and fatigue. Echocardiograms were negative for vegetations. The 18F-FDG PET/CT revealed an infective process of the valve and serological tests were positive for chronic Coxiella burnetii infection. Specific treatment for chronic Q fever endocarditis was, therefore, started and the response was monitored using 18F-FDG PET/CT. This case highlights the challenges and pitfalls clinicians face when confronted with prosthetic valve endocarditis and the use of 18F-FDG PET/CT for diagnosis and follow-up.
Keyphrases
- positron emission tomography
- computed tomography
- aortic valve
- mitral valve
- pet imaging
- pet ct
- palliative care
- magnetic resonance imaging
- aortic stenosis
- transcatheter aortic valve replacement
- case report
- transcatheter aortic valve implantation
- contrast enhanced
- electronic health record
- image quality
- combination therapy
- dual energy
- coronary artery
- machine learning
- drug induced
- ejection fraction
- replacement therapy
- smoking cessation
- atrial fibrillation