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Extracardiac complications in infective endocarditis: the role of 18-FDG-PET/CT
Session:
Posters (Sessão 4 - Écran 3) - Imagem multimodal 1
Speaker:
Gonçalo Ferraz Costa
Congress:
CPC 2023
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.6 Cross-Modality and Multi-Modality Imaging Topics
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Gonçalo Ferraz Costa; Gonçalo Terleira Batista; Joana Guimarães; Eric Monteiro; Diogo Fernandes; Tatiana Santos; Mariana Simões; Ana Luísa Silva; Ana Vera Marinho; Gracinda Costa; Lino Gonçalves; Maria João Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Background:</strong> The prevalence of extracardiac complications (ECC) of infective endocarditis (IE) is limited by the guideline-recommended diagnostic workup. Identification of ECC is one of the main contributions of 18-FDG-PET/CT.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Purpose</strong><strong>: </strong>Determine ECC prevalence and assess the role of 18-FDG-PET/CT.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> A retrospective analysis was performed at a tertiary center with 18F-FDG PET/CT and included all referred patients for this exam for suspected IE between May 2016 and January 2022. The choice to perform 18F-FDG PET/CT and the IE suspicion was based on the attending endocarditis team and did not follow a standardized protocol. Baseline demographic characteristics of patients, including all relevant clinical data, were collected from hospital records at hospital admission. The final diagnosis of IE (gold standard) was established by consulting the final diagnosis attributed to the patient by the Endocarditis team at the time of hospital discharge or death, after possession of clinical, microbiological, and imaging information as well as clinical response. ECC prevalence was analysed.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> In total, 87 patients were included (median age of 62 +/- 19 years, 62% of the male gender), of which 33 had a definitive diagnosis of IE. In this subgroup, approximately 67% were male, with a median age of 65 (IQR 53-74) years. Diabetes incidence was 21%, 58% had dyslipidemia and 58% were hypertensive. Fever was present in 85% of patients and 55% had signs of heart failure. Laboratory results showed a mean C-reactive protein of 12.4 mg/dL and a mean leucocyte count of 11.2 G/L. Only 61% had a positive blood culture. Echocardiographic findings suggesting IE were found in 58% and 36% presented moderate-severe valve regurgitation. We had an ECC prevalence of 15.2% (4 cases). The first and second patients had pacemaker electrode and pocket infection respectively, both leading to device removal. The third had purulent pericarditis, which resolved with conservative therapy. The last patient had splenic septic embolization, with a good response to antibiotic therapy.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion: </strong>18-FDG-PET/CT presents a valuable tool in assessing systemic involvement of patients with endocarditis.</span></span></p>
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