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. 2011 Sep;45(3):220-2.
doi: 10.1007/s13139-011-0088-6. Epub 2011 Jun 10.

Necrotizing Cervical Lymphadenitis Caused by Mycobacterium simiae in an HIV-Positive Patient: Imaging with (18)F-FDG PET/CT

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Necrotizing Cervical Lymphadenitis Caused by Mycobacterium simiae in an HIV-Positive Patient: Imaging with (18)F-FDG PET/CT

William Makis et al. Nucl Med Mol Imaging. 2011 Sep.

Abstract

Mycobacterium simiae (M. simiae) is an opportunistic pathogen rarely associated with human disease, although in recent years M. simiae has been detected with increasing frequency in human immunodeficiency virus (HIV)-infected patients, usually causing disseminated infection with fever, diarrhea and weight loss. We report the case of an HIV-positive man, who was referred for an (18)F-FDG PET/CT to evaluate a solitary pulmonary nodule. The PET/CT showed incidental large necrotic cervical lymph nodes, compatible with necrotizing cervical lymphadenitis. Biopsy and culture of one of the affected lymph nodes were positive for M. simiae. We present the first report of (18)F-FDG PET/CT imaging of an infectious process caused by M. simiae in humans.

Keywords: Fluorodeoxyglucose; HIV; Mycobacterium simiae; Necrotizing cervical lymphadenitis; PET/CT.

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Figures

Fig. 1
Fig. 1
A contrast-enhanced CT of the neck of a 43-year-old HIV-positive man, who presented with fever and sore neck of 2-week duration, showed bilateral mildly enlarged cervical level 2A lymph nodes, the largest measuring 2.5 cm × 2.0 cm on the left and 1.6 cm × 1.5 cm on the right (arrows)
Fig. 2
Fig. 2
18F-FDG PET/CT maximum intensity projection (MIP) images with (a) anterior and (b) left lateral views, done 2 months after the initial presentation for the evaluation of a solitary lung nodule, showed bilateral large necrotic lymph nodes in the neck and three right lower rib fractures
Fig. 3
Fig. 3
Transaxial views of (a) CT portion of the PET/CT, (b) PET and (c) PET/CT fusion images

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