Clinical indications for diagnostic FDG PET studies
| Patient | Age (y) | Clinical indication | PET reading | Biopsy | Organism | Clinical impact of PET | Follow up | ||||
| 1 | 5 | Pneumonia, fever | Active lesions (lung/mediastinum) | Yes (lung) | Act naeslundii | Adapted antimicrobial therapy according to resistance pattern | 4 PETs, slow improvement, but relapse | ||||
| Chronic lesions (abdomen) | |||||||||||
| Fever | Active lesions in the left lung, pleura, gut | Yes (lung, pleura) | Act naeslundii | Surgical intervention with pleurectomy after ineffective antimicrobial treatment, granulocyte infusions | 4 PETs, slow improvement, but relapse in pleural effusion | ||||||
| After pleurectomy at last follow up (1 year later) chronic non-active lesions | |||||||||||
| 2 | 16 | Prior BMT | Active lesions in the lung, neck, and gut | Yes (lung) | Paec variotii | Antifungal treatment with liposomal amphotericin B | 2 PETs, refused continuation of antifungal therapy, BMT omitted | ||||
| 3 | 8 | Prior BMT | Active lesions (lung, mediastinum, bone, and abdomen) | Yes (lung) | Asp nidulans | Antifungal treatment with liposomal amphotericin B, BMT | 1 PET, cured | ||||
| 4 | 16 | Prior BMT | Active lesion (lung) | Yes (lung) | Asp fumigatus | Persisting active lesion, liposomal amphotericin B, granulocyte transfusions during BMT | Diseased (severe GVHD IV), autopsy refused | ||||
| 5 | 15 | Prior BMT | Suspected active lesion (lung) | Yes (lung) | Asp fumigatus | Active lesion, BMT performed, liposomal amphotericin B administration | 1 PET, cured | ||||
| 6 | 16 | Prior BMT | Gastric active lesion | Yes (gastric) | Candida species | Antifungal prophylaxis with liposomal amphotericin B | 1 PET, cured | ||||
| 7 | 16 | Raised CRP, BSR (chron.) | Active lesion in the liver | Yes (liver) | Staph aureus | Drainage, antibiotic treatment | 1 PET, cured | ||||
CRP, C reactive protein; GVHD, graft versus host disease;Act, Actinomyces;Paec,Paecilomyces;Asp, Aspergillus.