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Information Journal Paper

Title

Case Series: Localization of acute pyelonephritis in pyrexia of unknown origin using FDG PET/CT

Pages

  79-83

Abstract

 Objective(s): Acute pyelonephritis presents with high-grade fever, dysuria, flank pain, leukocytosis, and microscopic hematuria. Urine culture aids in the diagnosis of this infection. It can be complicated or uncomplicated. Complicated pyelonephritis includes uncontrolled diabetes, transplant, pregnancy, acute or chronic renal failure, structural abnormality of the urinary tract, immunocompromised state, and hospital-acquired infections. Gram-negative bacteria commonly involved are Escherichia, Klebsiella, Proteus, and Enterobacter. The FDG PET/CT helps detect occult causes of fever, such as skeletal tuberculosis, thyroiditis, and lymphoma, when other investigations are inconclusive. We present three cases of pyrexia of unknown origin (PUO) in whom FDG PET/CT helped localize the focus of infection in the kidneys. Methods: The 18F-FDG PET/CT was performed on all three cases and images were acquired using the Biograph Horizon PET/CT system. Results: A cortical-based focus of FDG uptake was localized in the kidneys. The focus of abnormality was persistent following diuretic administration at 1-hour delayed regional image. Two cases had supportive evidence of pyelonephritis on DMSA scan. One case also had frank pus drained after DJ stenting of the affected side. All of them responded to treatment. Conclusion: Physiologic excretion of FDG in the urinary tract may interfere with the detection of the focus of infection in the kidneys on FDG PET/CT. However, occult infection in the kidneys may be detected with adequate precautions, such as the use of diuretics and delayed imaging, as illustrated in this case report. Routine investigations were noncontributory in all three cases presenting with PUO. However, FDG PET provided a diagnostic clue for pyelonephritis.

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    APA: Copy

    Solav, Shrikant, Savale, Shailendra, & Mahaveer Patil, Abhijit. (2020). Case Series: Localization of acute pyelonephritis in pyrexia of unknown origin using FDG PET/CT. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE AND BIOLOGY, 8(1), 79-83. SID. https://sid.ir/paper/764788/en

    Vancouver: Copy

    Solav Shrikant, Savale Shailendra, Mahaveer Patil Abhijit. Case Series: Localization of acute pyelonephritis in pyrexia of unknown origin using FDG PET/CT. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE AND BIOLOGY[Internet]. 2020;8(1):79-83. Available from: https://sid.ir/paper/764788/en

    IEEE: Copy

    Shrikant Solav, Shailendra Savale, and Abhijit Mahaveer Patil, “Case Series: Localization of acute pyelonephritis in pyrexia of unknown origin using FDG PET/CT,” ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE AND BIOLOGY, vol. 8, no. 1, pp. 79–83, 2020, [Online]. Available: https://sid.ir/paper/764788/en

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