Challenging case of chronic Q fever endocarditis: usefulness of 18F-FDG PET/CT in the diagnosis and follow-up

一例疑难慢性Q热心内膜炎病例:18F-FDG PET/CT在诊断和随访中的应用价值

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Abstract

Diagnosis of infective endocarditis can be challenging for clinicians, especially when involving prosthetic valves. Recent data suggest that (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-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 (18)F-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 (18)F-FDG PET/CT. This case highlights the challenges and pitfalls clinicians face when confronted with prosthetic valve endocarditis and the use of (18)F-FDG PET/CT for diagnosis and follow-up.

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