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Case Reports
. 2020 Jul-Sep;35(3):222-225.
doi: 10.4103/ijnm.IJNM_15_20. Epub 2020 Jul 1.

18-Fluorine-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in the Evaluation of the Great Masquerader Melioidosis: A Case Series

Pramukh Kulkarni  1 , Simon Shelley  1 , Indirani M Elangoven  1 , A Jaykanth  1 , Asra Patel Ejaz  1 , Nikita Sampathi Rao  1
Affiliations
Case Reports

18-Fluorine-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in the Evaluation of the Great Masquerader Melioidosis: A Case Series

Pramukh Kulkarni et al. Indian J Nucl Med. 2020 Jul-Sep.

Abstract

Melioidosis is an emerging infectious disease in India. The disease has a crippling effect on the patient owing to its widespread dissemination and complications post bacteremia. The role of 18-fluorine-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is becoming increasingly important in terms of documenting the extent of disease and response to treatment. Herein, we present cases of two patients who were referred for a whole-body 18F-FDG PET-CT scan with a history of long-standing fever that went undiagnosed. 18F-FDG PET-CT scan was performed to evaluate pyrexia of unknown origin. A conclusion was reached after blood culture which showed the growth of Burkholderia pseudomallei - which is considered to be the cause of this rare but debilitating disease.

Keywords: Burkholderia pseudomallei; emerging infection and 18-fluorine-fluorodeoxyglucose positron emission tomography–computed tomography; melioidosis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Multiple skin lesions over the right forearm
Figure 2
Figure 2
Chest X-ray showing multiple lobulated pleural-based opacities
Figure 3
Figure 3
Maximum intensity projection of the whole body 18-fluorine-fluorodeoxyglucose positron emission tomography–computed tomography image showing tracer uptake in the entire axial and appendicular skeleton, bilateral pulmonary nodules, and multiple lymph node levels
Figure 4
Figure 4
(a-c) Axial images (fused positron emission tomography–computed tomography, positron emission tomography, and computed tomography images, respectively) showing increased 18-fluorine-fluorodeoxyglucose uptake in multiple destructive lytic lesions with soft-tissue component and necrosis involving the right humerus
Figure 5
Figure 5
(a-c) Coronal images (fused positron emission tomography–computed tomography, positron emission tomography, and computed tomography images, respectively) showing focal increased 18-fluorine-fluorodeoxyglucose uptake in ill-defined hypodense lesions in the right lobe of the enlarged liver and the enlarged spleen
Figure 6
Figure 6
(a) Culture plate and (b) colonies of Burkholderia pseudomallei
Figure 7
Figure 7
(a-c) Coronal images (fused positron emission tomography–computed tomography, positron emission tomography, and computed tomography images, respectively) showing bulky left kidney with multiple ill-defined collections with micro- and macro-abscess in the upper and mid-pole with the largest collection measuring 5.5 cm × 3.0 cm. Corresponding increased 18-fluorine-fluorodeoxyglucose uptake was noted with SUVmax of 8.1
See this image and copyright information in PMC

References

    1. Whitmore AK, Krishnaswami CS. A hitherto undescribed infective disease in Rangoon. The Indian Medical Gazette. 1912;47:262. - PMC - PubMed
    1. Stanton AT, Fletcher W. Melioidosis, a new disease of the tropics. Trans Fourth Congr Far East Assoc Trop Med. 1921;2:196–8.
    1. Raja NS, Ahmed MZ, Singh NN. Melioidosis: An emerging infectious disease. J Postgrad Med. 2005;51:140–5. - PubMed
    1. Gopalakrishnan R, Sureshkumar D, Thirunarayan MA, Ramasubramanian V. Melioidosis: An emerging infection in India. J Assoc Physicians India. 2013;61:612–4. - PubMed
    1. Viswaroop BS, Balaji V, Mathai E, Kekre NS. Melioidosis presenting as genitourinary infection in two men with diabetes. J Postgrad Med. 2007;53:108–10. - PubMed

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