Femoropopliteal prosthetic bypass graft infection due to Mycobacterium abscessus localized by FDG-PET/CT scan.
A patient with postvascular graft placement presented with bacteremia but no localizing symptoms. Our standard infected graft workup of computed tomography (CT) scan, ultrasound scan, magnetic resonance imaging (MRI) scan, and additional laboratory tests did not localize the infection source. Nuclear medicine had three options including white blood cell (WBC) scan, gallium scan, and the fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET)/CT scan. FDG-PET/CT imaging alone demonstrated the location. We present an unusual case of Mycobacterium abscessus in a vascular graft not localized with CT scan, ultrasound scan, or MRI scan and could only be localized with FDG-PET/CT scan.
Marion
Michael D
MD
Department of Medical Education General Surgery Residency, Marshfield Clinic, Marshfield, WI 54449, USA. marion.michael@marshfieldclinic.org
Swanson
Mark K
MK
Spellman
Jeanne
J
Spieth
Michael E
ME
D000038:Abscess / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D000368:Aged; D017130:Angioplasty / Q000009:adverse effects* / Q000379:methods; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D020878:Device Removal; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D009161:Mycobacterium / Q000145:classification; D009164:Mycobacterium Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D011150:Popliteal Artery / Q000601:surgery; D049268:Positron-Emission Tomography / Q000379:methods*; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging* / Q000382:microbiology; D011859:Radiography; D012086:Reoperation; D018570:Risk Assessment; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D019788:Fluorodeoxyglucose F18