Infections involving the heart are becoming increasingly common, and a timely diagnosis of utmost importance, despite its challenges. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a recently introduced diagnostic tool in cardiology. This review focuses on the current evidence for the use of FDG PET/CT in the diagnosis of infective endocarditis, cardiac implantable device infection, left ventricular assist device infection, and secondary complications. The author discusses considerations when using FDG PET/CT in routine clinical practice, patient preparation for reducing physiologic myocardial uptake, acquisition of images, and interpretation of PET/CT findings. This review also functions to highlight the need for a standardized acquisition protocol.
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The Role of the 18F-FDG PET/CT in the Management of Patients Suspected of Cardiac Implantable Electronic Devices’ Infection Antonio Rosario Pisani, Dino Rubini, Corinna Altini, Rossella Ruta, Maria Gazzilli, Angela Sardaro, Francesca Iuele, Nicola Maggialetti, Giuseppe Rubini Journal of Personalized Medicine.2024; 14(1): 65. CrossRef
The detection of infectious endocarditis may be enhanced by a repeat FDG-PET while maintaining patients on a ketogenic diet Marine Germaini, Caroline Boursier, François Goehringer, Christine Selton-Suty, Benjamin Lefevre, Véronique Roch, Laetitia Imbert, Marine Claudin, Elodie Chevalier, Pierre-Yves Marie Journal of Nuclear Cardiology.2022; 29(6): 3256. CrossRef
Glomerulonephritis (GN) is sometimes associated with infective endocarditis (IE). Bartonella endocarditis is difficult to diagnose because it is rare and cannot be detected by blood culture. This is the first report of cytoplasmic anti-neutrophil cytoplasmic antibody-positive subacute endocarditis-associated GN caused by Bartonella infection in South Korea. A 67-year-old man was hospitalized due to azotemia. He complained of weight loss and anorexia for 6 months. A diagnosis of IE was made based upon echocardiographic detection of vegetations on the mitral and aortic valves and a Bartonella antibody titer of 1:2,048. Renal histology identified focal crescentic GN. Azotemia and proteinuria improved after doxycycline and rifampin treatment combining with steroid therapy.
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Clinicopathological differences between Bartonella and other bacterial endocarditis-related glomerulonephritis – our experience and a pooled analysis Mineaki Kitamura, Alana Dasgupta, Jonathan Henricks, Samir V. Parikh, Tibor Nadasdy, Edward Clark, Jose A. Bazan, Anjali A. Satoskar Frontiers in Nephrology.2024;[Epub] CrossRef
A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.
Loeffler's endocarditis involves progressive eosinophilic infiltration of the endocardium, which leads to apical thrombotic obliteration of the ventricle and endomyocardial fibrosis, that may finally represent a characteristic feature of restrictive cardiomyopathy. This paper presents a case of a 44-year-old male with symptoms of dyspnea and peripheral hypereosinophilia, who was diagnosed with early stage Loeffler's endocarditis via multicardiac imaging modalities.