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General Clinical Specialties: Infectious Disease/HematologyInfectious Disease/Hematology Posters |
1 Nuclear Medicine; 2 Internal Medicine; 3 Cardiology; 4 Microbiology; 5 MTA, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
1132
Objectives: Evaluation of FDG-PET when added to the regular diagnostic work-up of patients SAB.
Methods: All non-neutropenic adults with SAB between 11-05 and 8-07 were prospectively evaluated for risk factors for complicating infectious foci (treatment delay >48 hr, community acquisition, positive blood cultures >48 hr after start of treatment, persistent fever >72 hr). FDG-PET was performed within 14 days of the first positive blood culture.
Results: 98 patients with SAB were identified. 16 patients were not discharged from ICU within 14 days, 21 did not have any risk factors, and 11 refused FDG-PET. The results of 50 patients were analyzed. Metastatic foci were identified in 68% compared to 39% in a retrospective cohort (n=179), p=0.001. In 11 patients (22%) an endovascular focus was present. The chance of having complicating infectious foci was increased in the presence of 2 or more risk factors (p=0.056). Only one patient had a relapse of infection after completion of therapy, compared to 16 of 179 patients in the retrospective cohort (p=0.098).
Conclusions: The presence of two or more risk factors predicts the development of complicating infectious foci in patients with SAB. FDG-PET increased the detection of these foci. The intensive search for complicating infectious foci appears to reduce the number of relapses. To determine the exact role of FDG-PET in SAB, final results of this ongoing study have to be awaited.
Research Support: Supported bij ZonMW (DO 2005 #945-05-015)
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