Journal of Acute Care

Register      Login

VOLUME 2 , ISSUE 2 ( May-August, 2023 ) > List of Articles

CASE REPORT

Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Diagnosing Fever of Unknown Origin in Intensive Care Unit: A Case Report

Yathish Gattimallanahalli, Rajesh M Shetty, Manjunath Thimmappa, Nithya C Achaiah

Keywords : Case report, Fever of unknown origin, Positron emission tomography/computed tomography, Tuberculosis

Citation Information : Gattimallanahalli Y, Shetty RM, Thimmappa M, Achaiah NC. Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Diagnosing Fever of Unknown Origin in Intensive Care Unit: A Case Report. 2023; 2 (2):69-71.

DOI: 10.5005/jp-journals-10089-0072

License: CC BY-NC 4.0

Published Online: 30-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Fever of unknown origin (FUO) is defined as a temperature of 101°F (38.3°C) or higher with a minimum duration of 3 weeks without an established diagnosis after an intensive 1-week investigation in the hospital. A 56-year-old gentleman with ankylosing spondylitis receiving adalimumab presented with complaints of fever, pain abdomen, and loss of appetite. The patient was thoroughly investigated with a wide array of investigations, which included blood cultures, computed tomography (CT) chest and abdomen, and colonoscopy. The patient continued to have a fever without arriving at any diagnosis. Positron emission tomography/computed tomography (PET/CT) was done, which showed increased metabolic activity in both lung bases. Bronchoalveolar lavage was done, and tuberculosis (TB) GeneXpert on the sample was positive. This demonstrates that fluorodeoxyglucose (FDG)—PET/CT plays a vital role in investigations of FUO and arriving at a diagnosis.


HTML PDF Share
  1. Brown I, Finnigan NA. Fever of Unknown Origin. Treasure Island (FL): StatPearls, National Library of Medicine; 2023.
  2. van der Heijde D, Ramiro S, Landewé R, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis 2017;76(6):978–991. DOI: 10.1136/annrheumdis-2016-210770
  3. Roach DR, Bean AG, Demangel C, et al. TNF regulates chemokine induction essential for cell recruitment, granuloma formation, and clearance of mycobacterial infection. J Immunol 2002;168(9):4620–4627. DOI: 10.4049/jimmunol.168.9.4620
  4. Koo S, Marty FM, Baden LR. Infectious complications associated with immunomodulating biologic agents. Infect Dis Clin North Am 2010;24(2):285–306. DOI: 10.1016/j.idc.2010.01.006
  5. Roux C, Brocq O, Breuil V, et al. Safety of anti-TNF-alpha therapy in rheumatoid arthritis and spondylarthropathies with concurrent B or C chronic hepatitis. Rheumatology (Oxford). 2006;45(10):1294–1297. DOI: 10.1093/rheumatology/kel123
  6. Hastings R, Ding T, Butt S, et al. Neutropenia in patients receiving anti-tumor necrosis factor therapy. Arthritis Care Res (Hoboken) 2010;62(6):764–769. DOI: 10.1002/acr.20037
  7. Mohan N, Edwards ET, Cupps TR, et al. Demyelination occurring during anti-tumor necrosis factor alpha therapy for inflammatory arthritides. Arthritis Rheum 2001;44(12):2862–2869. DOI: 10.1002/1529-0131(200112)44:12<2862::aid-art474>3.0.co;2-w
  8. Kwon HJ, Cote TR, Cuffe MS, et al. Case reports of heart failure after therapy with a tumor necrosis factor antagonist. Ann Intern Med 2003;138(10):807–811. DOI: 10.7326/0003-4819-138-10-200305200-00008
  9. Bleeker-Rovers CP, Vos FJ, de Kleijn EMHA, et al. A prospective multicenter study on fever of unknown origin: the yield of a structured diagnostic protocol. Medicine 2007;86(1):26–38. DOI: 10.1097/MD.0b013e31802fe858
  10. Keidar Z, Gurman-Balbir A, Gaitini D, et al. Fever of unknown origin: the role of 18F-FDG PET/CT. J Nucl Med 2008;49(12):1980–1985. DOI: 10.2967/jnumed.108.054692
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.