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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 61

Fluorodeoxyglucose positron emission tomography in pyrexia of unknown origin


Department of Nuclear Medicine and PET, All India Institute of Medical Sciences, New Delhi 110 029, India

Date of Submission01-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Madhavi Tripathi
Department of Nuclear Medicine and PET, All India Institute of Medical Sciences, New Delhi 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1931_19

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How to cite this article:
Angamuthu M, Tripathi M. Fluorodeoxyglucose positron emission tomography in pyrexia of unknown origin. Indian J Med Res 2020;152, Suppl S1:61

How to cite this URL:
Angamuthu M, Tripathi M. Fluorodeoxyglucose positron emission tomography in pyrexia of unknown origin. Indian J Med Res [serial online] 2020 [cited 2021 Jul 29];152, Suppl S1:61. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/61/316741

A 77 yr old male presented to the department of Medicine, All India Institute of Medical Sciences, New Delhi, India, in September 2019, with fever of four-week duration with associated weight loss. Routine laboratory investigations revealed elevated erythrocyte sedimentation rate (43 mm/h; normal: 0-15 mm/h) and C-reactive protein (51.6 mg/l; normal: 0-6 mg/l). Ultrasound of the abdomen and computed tomography of the thorax and abdomen were non-contributory. Antibody workup for typhoid, Leptospira, scrub typhus, GeneXpert assay and interferon-gamma release immunoassay for tuberculosis were negative. The patient was referred for fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography with a diagnosis of pyrexia of unknown origin. FDG PET [Figure 1]A, [Figure 1]B, [Figure 1]C, [Figure 1]D, [Figure 1]E revealed increased FDG uptake along the walls of ascending aorta, arch and descending aorta, great vessels and vertebral and iliofemoral arteries suggestive of metabolically active large-vessel vasculitis. He was started on steroids and improved symptomatically on follow up.
Figure 1: Fluorine-18 fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) (A) maximum intensity projection image; (B-E) fused PET/CT coronal sections revealed intense tracer uptake in the wall of ascending aorta, arch and descending aorta, subclavian, abdominal aorta and its bifurcation consistent with metabolically active large-vessel vasculitis.

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FDG PET has proven utility in evaluating pyrexia of unknown origin.

Acknowledgment: Authors acknowledge Dr Sanjiv Sinha, department of Medicine, All India Institute of Medical Sciences, New Delhi, for referring the patient for PET scan.

Conflicts of Interest: None.


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