title: Late infectious endocarditis of surgical patch closure of atrial septal defects diagnosed by 18F-fluorodeoxyglucose gated cardiac computed tomography (18F-FDG-PET/CT): a case report.
abstract: BACKGROUND
  In contrast to percutaneous atrial septal occluder device, surgical patch closure of atrial defects was known to be no infective endocarditis risk.
  
  
  METHODS
  We herein report the first case of late endocarditis of surgical patch closure of atrial septal defects occurred at 47-year after surgery. On September 2014, a 56-year-old immunocompetent French Caucasian man was admitted into the Emergency Department for 3-week history of headache, acute decrease of psychomotor performance and fever at 40 °C. The diagnosis has been evoked during his admission for the management of a brain abscess and confirmed using 18F-fluorodeoxyglucose gated cardiac computed tomography (18F-FDG-PET/CT). Bacterial cultures of surgical deep samples of brain abscess were positive for Streptococcus intermedius and Aggregatibacter aphrophilus as identified by the matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry and confirmed with 16S rRNA gene sequencing. The patient was treated by antibiotics for 8 weeks and surgical patch closure removal.
  
  
  CONCLUSIONS
  In summary, late endocarditis on surgical patch and on percutaneous atrial septal occluder device of atrial septal defects is rare. Cardiac imaging by the 18F-fluorodeoxyglucose gated cardiac computed tomography (18F-FDG-PET/CT) could improve the diagnosis and care endocarditis on surgical patch closure of atrial septal defects while transthoracic and transesophageal echocardiography remained difficult to interpret.
authors.affiliation: Assistance Publique - Hôpitaux de Marseille (APHM), Service de Maladies Infectieuses, Hôpital de la Conception, 147, boulevard Baille, Marseille, France.|Aix Marseille Univ, INSERM 1095, CNRS 7278, IRD 198, URMITE, Marseille, France.
authors.forename: Estelle
authors.initials: E
authors.lastname: Honnorat
authors.affiliation: Assistance Publique - Hôpitaux de Marseille (APHM), Service de Maladies Infectieuses, Hôpital de la Conception, 147, boulevard Baille, Marseille, France. sengpiseth@yahoo.fr.|Aix Marseille Univ, INSERM 1095, CNRS 7278, IRD 198, URMITE, Marseille, France. sengpiseth@yahoo.fr.
authors.forename: Piseth
authors.identifier: http://orcid.org/0000-0002-0300-2728
authors.initials: P
authors.lastname: Seng
authors.affiliation: Department of Cardiac Surgery, La Timone Hospital, Aix-Marseille University, 13385, Marseille, France.
authors.forename: Alberto
authors.initials: A
authors.lastname: Riberi
authors.affiliation: Department of Cardiology, La Timone Hospital, Aix-Marseille University, Rue Saint-Pierre, 13385, Marseille, France.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Habib
authors.affiliation: Assistance Publique - Hôpitaux de Marseille (APHM), Service de Maladies Infectieuses, Hôpital de la Conception, 147, boulevard Baille, Marseille, France.|Aix Marseille Univ, INSERM 1095, CNRS 7278, IRD 198, URMITE, Marseille, France.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stein
mesh_terms: D001922:Brain Abscess / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000150:complications*; D019788:Fluorodeoxyglucose F18 / Q000737:chemistry*; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG-PET/CT; Aggregatibacter aphrophilus; Atrial septal defects; Bacteria; Brain abscess; Diagnosis; Human; Infection; Infective endocarditis; PET scan; Streptococcus intermedius; Surgical patch closure; Treatment