Whether the Valve or the Septic Embolus Is Actively Infectious:A Possible Role of Gallium-67 Scan in a Patient of Infective Endocarditis Complicated with Septic Emboli

區別心臟瓣膜或菌塊栓塞確實在感染中：鎵—67掃描在心內膜炎合併菌塊栓塞患者可扮演的角色

楊登堯(Teng-Yao Yang) ； 蔡名峰(Ming-Fong Tsai) ； 柯毓賢(Yu-Shien Ko) ； 鄭乃仁(Nye-Jan Cheng) ； 柯毓麟(Yu-Lin Ko)

《核子醫學雜誌》 15卷3期 (2002/09) Pp. 161-165

https://doi.org/10.6332/ANMS.1503.009

摘要

我們提出一位患有二尖瓣心內膜炎合併菌塊栓塞到右腳膕動脈的患者。病人在六周有效的抗生素治療後仍持續發燒但是血行動力學狀況穩定。心臟超音波顯示原本在二尖瓣上的菌塊已經消失，臨床現象及超音波和核磁共振血管攝影證實菌塊栓塞到右腳膕動脈。鎵-67掃描顯現出在右腳膕動脈而不是二尖瓣有較強的發炎反應。在栓塞摘除術後，病人的燒就退了。我們認為鎵-67掃描在這個情況下可能可以幫忙找出真正的感染源而避免不必要的心臟手術。

關鍵字

感染性心內膜炎 ； 菌塊栓塞 ； 鎵—67炎癥掃描

並列摘要

We reported a case of infective endocarditis involving the mitral valve and complicated with septic embolus to the right popliteal artery. After 6 weeks of antibiotic treatment, hemodynamic condition of the patient was stable but fever persisted. Echocardiography showed disappearance of the vegetation that was seen on the initial echocardiogram. Occlusion of the right popliteal artery by septic emboli was suspected by clinical findings and proved by duplex and magnetic resonance angiogram. Gallium-67 (67Ga) scan revealed increased uptake over the right leg but not the heart. After
embolectomy (without open heart surgery), the fever subsided. This case report suggests the possibility that 67Ga scan may play a role in this situation to find the infectious focus and avoid unnecessary open heart surgery.

並列關鍵字

infective endocarditis ； septic embolism ； 67Ga inflammation scan