title: Diagnosing pulmonic valve infective endocarditis with positron emission tomography-CT.
abstract: Infective endocarditis (IE) affects the pulmonic valve in less than 2% of cases. Not only is pulmonary valve IE rare, it is also challenging to visualise with commonly used imaging modalities. In this vignette, we present a 50-year-old patient with a history of repaired Tetralogy of Fallot who underwent a prolonged hospitalisation and extensive work up for fever of unknown origin. Although we suspected IE as the source of his fevers, he had persistently negative transthoracic and transoesophageal echocardiograms. We were ultimately able to establish the diagnosis with the use of positron emission tomography-CT (PET-CT). Although PET-CT is not part of the traditional work up for IE, it can be a useful imaging modality when there is a high index of suspicion for IE with negative echocardiography findings.
authors.affiliation: Department of Internal Medicine, Duke University Health System, Durham, North Carolina, USA.
authors.forename: Kahli
authors.initials: K
authors.lastname: Zietlow
authors.affiliation: Department of Internal Medicine, Duke University Health System, Durham, North Carolina, USA.
authors.forename: Taylor C
authors.initials: TC
authors.lastname: Bazemore
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Duke University Health System, Durham, North Carolina, USA.
authors.forename: Kishan S
authors.initials: KS
authors.lastname: Parikh
mesh_terms: D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005334:Fever / Q000209:etiology; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D011664:Pulmonary Valve / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18
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