title: 18F-FDG PET/CT as a central tool in the shift from chronic Q fever to Coxiella burnetii persistent focalized infection: A consecutive case series.
abstract: Because Q fever is mostly diagnosed serologically, localizing a persistent focus of Coxiella burnetii infection can be challenging. F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) could be an interesting tool in this context.We performed a retrospective study on patients diagnosed with C burnetii infection, who had undergone F-FDG PET/CT between 2009 and 2015. When positive F-FDG PET/CT results were obtained, we tried to determine if it changed the previous diagnosis by discovering or confirming a suspected focus of C burnetii infection.One hundred sixty-seven patients benefited from F-FDG PET/CT. The most frequent clinical subgroup before F-FDG PET/CT was patients with no identified focus of infection, despite high IgG1 serological titers (34%). For 59% (n = 99) of patients, a hypermetabolic focus was identified. For 62 patients (62.6%), the positive F-FDG PET/CT allowed the diagnosis to be changed. For 24 of them, (38.7%), a previously unsuspected focus of infection was discovered. Forty-two (42%) positive patients had more than 1 hypermetabolic focus. We observed 21 valvular foci, 34 vascular foci, and a high proportion of osteoarticular localizations (n = 21). We also observed lymphadenitis (n = 27), bone marrow hypermetabolism (n = 11), and 9 pulmonary localizations.We confirmed thatF-FDG PET/CT is a central tool in the diagnosis of C burnetii focalized persistent infection. We proposed new diagnostic scores for 2 main clinical entities identified using F-FDG PET/CT: osteoarticular persistent infections and lymphadenitis.
authors: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine, CNRS UMR 7278, IRD 198, Aix-Marseille Université, 27 Bd Jean Moulin Service de médecine nucléaire, Hôpital de La Timone, Marseille Service de pathologies infectieuses et tropicales de l'hôpital de Nimes Service de médecine, Hôpital de Chatellerault Unité Nord Insuffisance cardiaque et valvulopathies (UNIV), Service de cardiologie CHU de Marseille, Hôpital Nord, AP-HM Chemin des Bourrely, Marseille Service de Pathologies infectieuses et tropicales, CHU de Poitiers Service de Médecine interne Hôpital de Gap Service de Médecine interne, hôpital Saint Luc, Lyon Service de Rhumatologie, Centre hospitalier de Vienne Service de Pathologies infectieuses et tropicales, CHU de Rouen Service de Pathologies infectieuses et tropicales, CHU de Tours Service de Médecine Interne, CH de Bourges Service de Médecine Interne, Hôpital Saint-Anne, Toulon Service mobile d'Infectiologie, CH Victor Dupouy, Argenteuil Service de Médecine interne, CHU de Nantes, France.
authors: Carole
authors: C
authors: Eldin
authors: Cléa
authors: C
authors: Melenotte
authors: Matthieu
authors: M
authors: Million
authors: Serge
authors: S
authors: Cammilleri
authors: Albert
authors: A
authors: Sotto
authors: Antoine
authors: A
authors: Elsendoorn
authors: Franck
authors: F
authors: Thuny
authors: Hubert
authors: H
authors: Lepidi
authors: France
authors: F
authors: Roblot
authors: Thierry
authors: T
authors: Weitten
authors: Souad
authors: S
authors: Assaad
authors: Anissa
authors: A
authors: Bouaziz
authors: Claire
authors: C
authors: Chapuzet
authors: Guillaume
authors: G
authors: Gras
authors: Anne-Sophie
authors: AS
authors: Labussiere
authors: Cécile
authors: C
authors: Landais
authors: Pascale
authors: P
authors: Longuet
authors: Agathe
authors: A
authors: Masseau
authors: Olivier
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authors: Mundler
authors: Didier
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authors: Raoult
mesh_terms: D000328:Adult; D000368:Aged; D001850:Bone Diseases, Infectious / Q000000981:diagnostic imaging* / Q000382:microbiology; D016997:Coxiella burnetii; D004696:Endocarditis / Q000000981:diagnostic imaging* / Q000382:microbiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D008199:Lymphadenitis / Q000000981:diagnostic imaging* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging / Q000382:microbiology; D000072078:Positron Emission Tomography Computed Tomography; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging* / Q000382:microbiology; D011778:Q Fever / Q000097:blood / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology
chemical_list: D007136:Immunoglobulins; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18