Vasculitis of ascending aorta detected on FDG PET/CT in a patient with fever of unknown origin

A 59-year-old man was admitted for fever of unknown origin. Fever was associated with chills. His medical record revealed the history of aortic valve replacement 11 years earlier, as well as enterococcal endocarditis 4 months prior to the current admission. The patient was found to have normal left ventricular size with borderline systolic function, left ventricular hypertrophy, right ventricle at the upper limit of normal size, mild systolic dysfunction and mild transvalvular aortic insufficiency on transthoracic echocardiography; while no vegetations were observed on transesophageal echocardiography. Sequential blood cultures were negative; however, a blood culture sample obtained 5 days prior to last admission was shown to be positive for enterococci. In addition, persistently increased levels of erythrocyte sedimentation rate and C reactive protein at 48 mm/hour and 39 mg/L were noted, respectively. Subsequently, the patient underwent fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG-PET/CT) in search for the origin of the fever, which...
Source: Heart Asia - Category: Cardiology Authors: Tags: Images in cardiovascular medicine Source Type: research