Ostesyntesis-associated infection by S. aureus and the role of PET/CT in the diagnosis of septic complications

Roa-Chamorro, R.; Godoy-Montijano, A.; Moral-Ruiz, A.

doi:10.1016/j.rceng.2020.01.012

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Methicillin-sensitive Staphylococcus aureus was isolated. During the hospitalization, he started having lumbar pain that was highly localized to the L4-L5 area without fever or other clinical symptoms. Of note on the blood test was a sustained elevation of CRP (peak of 272 mg/L).In light of a suspicion of infectious spondylodiscitis, an 18F-FDG PET/CT scan was requested. It showed increased metabolic uptake in the L4-L5 area suggestive of the pathology with a SUVmax of 4.1 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B) and no involvement of the lumbar osteosynthesis material. There was increased uptake in the left supraclavicular fossa around the pacemaker, with a SUVmax of 3.2, and along the path of the pacemaker lead, with a SUVmax of 2.9 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and C).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The suspicion of infectious endocarditis was confirmed with a transesophageal echocardiogram in which a mobile mass measuring 15 × 8 mm was observed in the atrial face of the tricuspid valve posterior leaflet compatible with vegetation/infectious endocarditis.Initially treated with cloxacillin and daptomycin, the patient was operated on; the pacemaker system was removed and a new dual-chamber pacemaker was implanted. S. aureus was isolated in a culture of the extracted system.We believe that he presented with S. aureus bacteremia whose initial focal point was infection of the left foot arthrodesis. This led to the onset of infectious endocarditis and later vertebral septic embolism. The 18F-FDG PET/CT scan played a key role in the diagnosis, as it provided additional information with respect to other imaging tests, detecting hidden focal points of inflammation and infection." "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-11-21" "fechaAceptado" => "2020-01-16" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Roa-Chamorro R, Godoy-Montijano A, Moral-Ruiz A. Infección de material de osteosíntesis por S. aureus y la utilidad del PET/TC en el diagnóstico de las complicaciones sépticas. 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Vol. 222. Issue 2.

Pages 112-113 (February 2022)

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