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CASE REPORT
Year : 2012  |  Volume : 11  |  Issue : 1  |  Page : 22-23

18 F-FDG Positron Emission Tomography in Multifocal Pyomyositis


1 Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication19-Jul-2012

Correspondence Address:
B R Mittal
Professor and Head, Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
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DOI: 10.4103/1450-1147.98741

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   Abstract 

18 F-Fluoro-deoxyglucose-positron emission tomography/computed tomography findings in a case presenting with pyomyositis are presented in this report.

Keywords: Pyomyositis, 18 F-FDG, PET/CT


How to cite this article:
Harisankar C, Mittal B R, Kashyap R, Bhattacharya A, Singhi S. 18 F-FDG Positron Emission Tomography in Multifocal Pyomyositis. World J Nucl Med 2012;11:22-3

How to cite this URL:
Harisankar C, Mittal B R, Kashyap R, Bhattacharya A, Singhi S. 18 F-FDG Positron Emission Tomography in Multifocal Pyomyositis. World J Nucl Med [serial online] 2012 [cited 2019 Dec 9];11:22-3. Available from: http://www.wjnm.org/text.asp?2012/11/1/22/98741


   Introduction Top


Pyomyositis is a suppurative infection of the skeletal muscle and usually involves numerous muscles. It affects all age groups and represents a diagnostic and therapeutic challenge to clinicians, radiologists and pathologists. Ultrasonography and computed tomography remain the main imaging modalities. Early diagnosis allows prompt treatment which can prevent unwanted complications. FDG PET/CT can also be performed to find out the involvement of various sites in one go and hence help in the management.


   Case Report Top


A 7-year-old boy presented with fever, cough with expectoration, weakness, and pain at multiple sites in the body. On examination, he had multiple swellings associated with erythema and tenderness all over the body. An ultrasound examination of the thigh revealed evidence of pyomyositis. Aspiration and culture was positive for Staphylococcus aureus. He was subjected to an 18 F-fluoro-deoxyglucose-positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) to evaluate the extent of disease involvement. PET revealed FDG uptake in multiple muscles with many of them showing the evidence of abscess formation [Figure 1]. Apart from the muscle uptake, multiple FDG avid pulmonary nodules were also noted. The child was treated with a combination of intensive antibiotic therapy and drainage of the abscesses.
Figure 1: 18F-fluoro-deoxyglucose (FDG) positron emission tomography (PET) showing multiple foci of FDG uptake in multiple muscles all over the body. Many of the lesions show central areas of photon-deficiency suggestive of abscess formation. Apart from the muscles uptake, multiple FDG avid pulmonary nodules are also noted

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   Discussion Top


Pyomyositis is a primary, subacute, deep bacterial infection of the skeletal muscle that usually manifests itself as localized abscess formations. Multifocal staphylococcal infection in immune-competent host is an infrequently described entity. [1],[2] Management of this entity requires an aggressive approach of intensive antimicrobial therapy and surgical drainage. FDG-PET is being increasingly used in the evaluation of a variety of complicated infections, including diabetic foot as well as vascular and orthopedic prosthesis infections. [3],[4],[5] FDG-PET would play an important role in patients with disseminated infection in evaluating the sites and extent of involvement; as well as in the followup evaluation of such cases after institution of specific treatments.

 
   References Top

1.Niamane R, Jalal O, El Ghazi M, Hssaida R, Had A. Multifocal pyomyositis in an immuno-competent patient. Joint Bone Spine 2004;71:595-7.  Back to cited text no. 1
[PUBMED]    
2.Gomez RN, Duran MO. Pyomyositis, sacroiliitis and spondylodiscitis caused by Staphylococcus hominis in an immunocompetent woman. An Med Interna 2006;23:582-4.  Back to cited text no. 2
    
3.Nawaz A, Torigian DA, Siegelman ES, Basu S, Chryssikos T, Alavi A. Diagnostic performance of FDG-PET, MRI, and plain film radiography (PFR) for the diagnosis of osteomyelitis in the diabetic foot. Mol Imaging Biol 2010;12:335-42.  Back to cited text no. 3
[PUBMED]    
4.Keidar Z, Engel A, Hoffman A, Israel O, Nitecki S. Prosthetic vascular graft infection: the role of 18F-FDG PET/CT. J Nucl Med 2007;48:1230-6.  Back to cited text no. 4
[PUBMED]    
5.Basu S, Chryssikos T, Moghadam-Kia S, Zhuang H, Torigian DA, Alavi A. Positron emission tomography as a diagnostic tool in infection: present role and future possibilities. Semin Nucl Med 2009;39:36-51.  Back to cited text no. 5
    


    Figures

  [Figure 1]


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[Pubmed] | [DOI]



 

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