title: Demonstration of different patterns of musculoskeletal, soft tissue and visceral involvement in melioidosis using 99m Tc stannous colloid white cell scanning.
abstract: Melioidosis is an infectious disease that can present with multiple foci of disease involvement. Assessment of disease extent can be difficult, especially in musculoskeletal, visceral and soft tissue infection. This study examined the usefulness of white cell scans in this condition. 99mTc stannous colloid white cell scanning was performed in 21 patients with culture-proven melioidosis. Scan results were compared with clinical assessment and correlated with other forms of imaging. White cell scans demonstrated all but one of the clinically apparent sites of musculoskeletal, visceral and other soft tissue infection. Unsuspected disseminated soft tissue lesions were seen in two patients, including femoral node uptake in both, and these patients subsequently presented with relapsing musculoskeletal disease. Unsuspected musculoskeletal disease was found in one patient. Clinically suspected musculoskeletal disease was accurately excluded by white cell scan in another patient. The results of white cell scanning were also examined in disease of other viscera. Renal and prostatic disease were visualized. Unsuspected parotid involvement was found in two patients. Only one of two spinal lesions was visualized. Pulmonary disease was not necessarily associated with abnormal uptake. White cell scanning is a quick and effective way of assessing the extent of musculoskeletal, visceral and soft tissue disease in melioidosis.
authors.affiliation: Townsville General Hospital, Queensland, Australia. Stuart_Ramsay@health.qld.gov.au
authors.forename: S C
authors.initials: SC
authors.lastname: Ramsay
authors.forename: J
authors.initials: J
authors.lastname: Labrooy
authors.forename: R
authors.initials: R
authors.lastname: Norton
authors.forename: B
authors.initials: B
authors.lastname: Webb
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008297:Male; D008554:Melioidosis / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009141:Musculoskeletal System / Q000000981:diagnostic imaging; D011859:Radiography; D018461:Soft Tissue Infections / Q000000981:diagnostic imaging; D017556:Technetium Compounds / Q000493:pharmacokinetics / Q000627:therapeutic use*; D017971:Tin Compounds / Q000493:pharmacokinetics / Q000627:therapeutic use*; D014018:Tissue Distribution; D014781:Viscera / Q000000981:diagnostic imaging
chemical_list: D017556:Technetium Compounds; D017971:Tin Compounds; C033493:technetium Tc 99m tin colloid