Utility of 18 F-FDG PET/CT scan to diagnose the etiology of fever of unknown origin in patients on dialysis.
Studies on fever of unknown origin (FUO) in patients of chronic kidney disease and end stage renal disease patients on dialysis were not many. In this study, we used 18 F-FDG PET/CT scan whole body survey for detection of hidden infection, in patients on dialysis, labelled as FUO.



In this retrospective study, 20 patients of end stage renal disease on dialysis were investigated for the cause of FUO using 18F-FDG PET/CT scan. All these patients satisfied the definition of FUO as defined by Petersdorf and Beeson. Any focal abnormal site of increased FDG concentration detected by PET/CT, either a solitary or multiple lesions was documented and at least one of the detected abnormal sites of radio tracer concentration was further examined for histopathology.



All patients were on renal replacement therapy. Of these, 18 were on hemodialysis and two were on peritoneal dialysis. 18F-FDG PET/CT scan showed metabolically active lesions in 15 patients and metabolically quiescent in five patients. After 18F-FDG PET/CT scan all, but one patient had a change in treatment for fever. Anti-tuberculous treatment was given in 15 patients, antibiotics in four patients and anti-malaria treatment in one patient.



The present study is first study of 18F-FDG PET/CT scan in patients of end stage renal disease on dialysis with FUO. The study showed that the 18 F FDG PET/CT scan may present an opportunity to attain the diagnosis in end stage renal disease patients on dialysis with FUO.
Department of Nuclear Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, 517507, India.
Kalawat
K
Tek Chand
Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, 517507, India.
Krishna Kishore
KK
Chennu
Department of Radiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, 517507, India.
Lakshmi
L
Amancharla Yadagiri
Department of Nuclear Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, 517507, India.
Ranadheer
R
Manthri Gupta
Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, 517507, India.
Ram
R
Rapur
Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, 517507, India.
Siva Kumar
SK
Vishnubotla
D000328:Adult; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis*; D019788:Fluorodeoxyglucose F18 / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D019788:Fluorodeoxyglucose F18
18 F-FDG PET/CT scan; dialysis; fever of unknown origin; malaria; osteomyelitis; tuberculosis