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Fluorodeoxyglucose positron emission tomography in pyrexia of unknown origin
*For correspondence: madhavi.dave.97@gmail.com
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Received: ,
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
A 77 yr old male† presented to the department of Medicine, All India Institute of Medical Sciences, New Delhi, India, in September 2019, with fever of four-week duration with associated weight loss. Routine laboratory investigations revealed elevated erythrocyte sedimentation rate (43 mm/h; normal: 0-15 mm/h) and C-reactive protein (51.6 mg/l; normal: 0-6 mg/l). Ultrasound of the abdomen and computed tomography of the thorax and abdomen were non-contributory. Antibody workup for typhoid, Leptospira, scrub typhus, GeneXpert assay and interferon-gamma release immunoassay for tuberculosis were negative. The patient was referred for fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography with a diagnosis of pyrexia of unknown origin. FDG PET (Figure A-E) revealed increased FDG uptake along the walls of ascending aorta, arch and descending aorta, great vessels and vertebral and iliofemoral arteries suggestive of metabolically active large-vessel vasculitis. He was started on steroids and improved symptomatically on follow up.
- Fluorine-18 fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) (A) maximum intensity projection image; (B-E) fused PET/CT coronal sections revealed intense tracer uptake in the wall of ascending aorta, arch and descending aorta, subclavian, abdominal aorta and its bifurcation consistent with metabolically active large-vessel vasculitis.
FDG PET has proven utility in evaluating pyrexia of unknown origin.
Acknowledgment:
Authors acknowledge Dr Sanjiv Sinha, department of Medicine, All India Institute of Medical Sciences, New Delhi, for referring the patient for PET scan.
Conflicts of Interest: None.
