4.7 Article

F-18-fluorodeoxyglucose positron emission tomography leading to a diagnosis of septic thrombophlebitis of the portal vein: description of a case history and review of the literature

Journal

JOURNAL OF INTERNAL MEDICINE
Volume 255, Issue 3, Pages 419-423

Publisher

BLACKWELL PUBLISHING LTD
DOI: 10.1046/j.1365-2796.2003.01259.x

Keywords

F-18-fluorodeoxyglucose; fever of unknown origin (FUO); positron emission tomography; pylephlebitis; septic thrombophlebitis

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Pylephlebitis or septic thrombophlebitis of the portal vein is a serious infectious disorder. Early diagnosis is difficult, due to nonspecific symptoms and signs, limitations of diagnostic modalities and the lack of familiarity of physicians with this entity. We report the history of a 73-year-old man with fever of unknown origin (FUO) in whom laboratory tests, blood and urine cultures, chest X-ray, abdominal ultrasound, and Indium-111-leucocyte scintigraphy did not reveal the cause of the fever. F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) subsequently pointed to the diagnosis of pylephlebitis, which was confirmed by computed tomography (CT) and percutaneous puncture. We conclude that FDG PET allows detecting inflammatory foci in patients with FUO and offers to make the diagnosis of pylephlebitis at an early stage.

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