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. 2023 Apr-Jun;38(2):157-159.
doi: 10.4103/ijnm.ijnm_148_21. Epub 2023 Jun 8.

Disseminated Nocardia farcinica Infection and Treatment Response on F-18 Fludeoxyglucose Positron Emission Tomography Computed Tomography

Kevser Oksuzoglu  1 , Selin Kesim  1 , Halil Turgut Turoglu  1 , Elif Tukenmez Tigen  2 , Nurver Ulger  3 , Tanju Yusuf Erdil  1
Affiliations

Disseminated Nocardia farcinica Infection and Treatment Response on F-18 Fludeoxyglucose Positron Emission Tomography Computed Tomography

Kevser Oksuzoglu et al. Indian J Nucl Med. 2023 Apr-Jun.

Abstract

We report a rare case of nocardiosis with increased F-18 Fludeoxyglucose (F-18 FDG) uptake in widespread abscess foci of Nocardia farcinica infection in an immunocompromised patient on positron emission tomography computed tomography (PET/CT) imaging. A relatively infrequent cause of nocardiosis, N. farcinica is an opportunistic infection that may present with clinically aggressive disseminated disease. Whole-body F-18 FDG-PET/CT allows identifying the extent of disease, as well as monitoring response to therapy in patients with nocardiosis especially the disseminated form.

Keywords: Disseminated nocardiosis; F-18 fludeoxyglucose positron emission tomography computed tomography; Nocardia farcinica.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Coronal maximum intensity projection (MIP) (a) and axial fused PET/CT images (b) revealed mild FDG uptake (SUVmax = 1.7) in the cavitary lesion measuring 10 mm × 20 mm in the middle lobe of the right lung (arrowhead). In addition, intense FDG uptake secondary to granulocyte and macrophage activation was noted in widespread subcutaneous and soft tissue infection and abscesses on trunk and extremities, involving the right thigh (arrows). After an 8-week course of trimethoprim/sulfamethoxazole, imipenem, and moxifloxacin treatment, a repeat FDG PET/CT scan (c; coronal MIP, d; axial fused PET/CT images) revealed favorable metabolic response to therapy
Figure 2
Figure 2
Modified Ziehl–Neelsen stain of gluteal abscess culture showed acid-fast branching filamentous Nocardia spp
See this image and copyright information in PMC

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