Role of PET/CT in Evaluating for Occult Gram-Positive Bacteremia

Excerpt

A 67-year-old man with a history of ascending thoracic aneurysm, asthma, and schizophrenia presented with tachypnea after cardiac catheterization. Exam showed increased work of breathing. Blood cultures grew methicillin-susceptible Staphylococcus aureus (MSSA), which was treated with intravenous cefazolin. Despite treatment, the patient remained persistently bacteremic. An exhaustive search for a source proved unfruitful; notably, a transthoracic echocardiogram (TTE) showed no evidence of endocarditis. A whole-body PET/CT was then conducted to evaluate for occult sources. This study showed a T2 vertebrae with osteomyelitis (red arrow), right glenohumeral edema with soft tissue infection (yellow arrows), and a 4.8-cm infrarenal mycotic aortic aneurysm (white arrows).

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