Abstract
We present a 54-year-old woman with systemic lupus erythematosus (SLE), fever, pericardial effusion and a mitral valve vegetation. (18)F-Fluorodesoxyglucose positron emission tomography CT ((18)F-FDG-PET-CT) showed very high accumulation of the isotope at the mitral valve. The patient underwent cardiothoracic surgery and pathologic examinations showed characteristic morphology of Libman-Sacks vegetations. All microbiological examinations including blood cultures, microscopy, culture and 16s PCR of the valve were negative and the diagnosis of Libman-Sacks endocarditis was convincing. It is difficult to distinguish Libman-Sacks endocarditis from culture-negative infective endocarditis (IE). Molecular imaging techniques are being used increasingly in cases of suspected IE but no studies have previously reported the use in patients with Libman-Sacks endocarditis. In the present case, (18)F-FDG-PET-CT clearly demonstrated the increased glucose uptake caused by infiltrating white blood cells in the ongoing inflammatory process at the mitral valve. In conclusion, (18)F-FDG-PET-CT cannot be used to distinguish between IE and non-infective Libman-Sacks vegetations.
| Original language | English |
|---|---|
| Journal | Infectious Diseases |
| Volume | 47 |
| Issue number | 4 |
| Pages (from-to) | 263-6 |
| Number of pages | 4 |
| ISSN | 1178-6337 |
| DOIs | |
| Publication status | Published - Apr 2015 |
Keywords
- Endocarditis
- Female
- Heart Valve Prosthesis Implantation
- Humans
- Lupus Erythematosus, Systemic
- Middle Aged
- Mitral Valve
- Molecular Imaging