Use of 99mTc-mononuclear leukocyte scintigraphy in nosocomial fever.
OBJECTIVE
To determine the overall diagnostic accuracy of mononuclear leukocyte- 99mTc scintigraphy in the routine detection of infectious lesions and fever of unknown origin (FUO) in inpatients.


METHODS
The use of mononuclear leukocyte 99mTc scintigraphy is presented in 87 patients who fulfilled the Durack and Street diagnostic criteria of nosocomial FUO; 66 patients were suspected of having infectious lesions (myocarditis, endocarditis, infected catheters, diabetic foot, and osteomyelitis) and 21 patients presented with unknown causes of FUO. Scans were carried out 1, 3, and 24 h after injection of labeled leukocytes.


RESULTS
In three cases (3/27) where scintigraphs were negative, biopsies were positive. There were two (2/87) false-positive scintigrams. We found a 95.8% sensitivity and 92.3% specificity. PPV was 93.8%, PPN 94.7%, and accuracy 94.2%.


CONCLUSIONS
Mononuclear leukocyte 99mTc scintigraphy showed high sensitivity, specificity, positive and negative predictive values in patients with nosocomial FUO. These results suggest an important role for nuclear medicine in the management of patients with infection/inflammation.
Gutfilen
B
B
Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil. bgutfilen@hucff.uffj.br
Lopes de Souza
S A
SA
Martins
F P P
FP
Cardoso
L R
LR
Pinheiro Pessoa
M C
MC
Fonseca
L M B
LM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003428:Cross Infection / Q000000981:diagnostic imaging*; D005260:Female; D005335:Fever of Unknown Origin / Q000000981:diagnostic imaging*; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013667:Technetium
D019275:Radiopharmaceuticals; D013667:Technetium