Page 68 - ARNM-2-2

Advances in Radiotherapy &

Nuclear Medicine

CASE REPORT
18 F-FDG PET/CT for the diagnosis and

evaluation of antibiotic response in patients
with left ventricular assistive device infection: A

case report

Lijuan Di 1† , Guangyu Zhao 1† , Shanshi Li 2 , Bo Zheng , and Yan Fan *
3
1
1 Department of Nuclear Medicine, Peking University First Hospital, Beijing, China
2 Department of Radiation Oncology, Peking University First Hospital, Beijing, China
3 Institute of Clinical Pharmacology, Peking University First Hospital, Beijing, China

Abstract

The left ventricular assistive device (LVAD) is critical for end-stage heart failure
patients. Centrifugal flow LVAD recipients have a 4-year survival rate of nearly 60%,
with infection occurring in over 50% of patients within 2 years. Herein, we report a
case of LVAD infection in a 60-year-old man. The patient presented with fever after
49 days following LVAD implantation. Culture of both blood and areas around the
† These authors contributed equally outflow cannula indicated an infection with Enterobacter cloacae and Staphylococcus
to this work. aureus. After sequential treatment with meropenem and daptomycin, as well as
*Corresponding author: abdominal incisional debridement, the patient’s symptoms of fever disappeared,
Yan Fan but the inflammatory markers, such as the erythrocyte sedimentation rate (ESR)
(fanyan@bjmu.edu.cn)
and C-reactive protein (CRP) level, remained abnormal. Five F-fluorodeoxyglucose
18
Citation: Di L, Zhao G, Li S, positron emission tomography/computed tomography ( F-FDG PET/CT) scans
18
18
Zheng B, Fan Y. F-FDG were performed to evaluate the infection. PET/CT revealed infected lesions around
PET/CT for the diagnosis and
evaluation of antibiotic response the lower segment of the outflow cannula with high FDG uptake. After continuous
in patients with left ventricular oral antibiotic treatment for more than 1 year, the infected areas with high FDG
assistive device infection: A case uptake around the outflow cannula gradually declined and eventually disappeared,
report. Adv Radiother Nucl Med.
2024;2(2):3690. consistent with the noted changes in both ESR and CRP levels in the serum. Multiple
doi: 10.36922/arnm.3690 continuous F-FDG PET/CT scans can distinguish high FDG uptake areas of infection
18
Received: May 17, 2024 from sterile inflammatory areas, assisting in the accurate diagnosis of infection and
evaluation of antibiotic treatment after LVAD implantation.
Accepted: June 17, 2024
Published Online: July 1, 2024
Keywords: Fluorodeoxyglucose; PET/CT; Infections; Heart assist device
Copyright: © 2024 Author(s).
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution, 1. Background
and reproduction in any medium,
provided the original work is The left ventricular assistive device (LVAD) is essential for end-stage heart failure
properly cited. patients, serving either as a bridge for heart transplantation or as destination therapy.
1
2
Publisher’s Note: AccScience The 4-year survival rate of centrifugal flow LVAD recipients is nearly 60%. Infection is a
Publishing remains neutral with common adverse event that occurs in more than 50% of patients treated with LVADs for
regard to jurisdictional claims in 3
published maps and institutional 2 years. Infection is accompanied by increased glucose utilization, which can be detected
affiliations by 18 F-fluorodeoxyglucose positron emission tomography/computed tomography

Volume 2 Issue 2 (2024) 1 doi: 10.36922/arnm.3690