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The present study is first study of 18F-FDG PET/CT scan in patients of end stage renal disease on dialysis with FUO. The study showed that the 18 F FDG PET/CT scan may present an opportunity to attain the diagnosis in end stage renal disease patients on dialysis with FUO.

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An elderly lady came to the casualty department with abdominal pain and vomiting of 1 day duration. She responded to symptomatic treatment. Hence she requested a discharge. The next day she was readmitted with severe breathlessness. Evaluation this time revealed a large right sided pleural effusion. The effusion was drained through an intercostal tube. The fluid was a transudate. Large amount of fluid was drained out of the intercostal tube daily. Detailed evaluation to decipher the cause of transudative effusion pointed to underlying cirrhosis of liver. Presence of a transudative pleural effusion in the absence of a significant ascitis suggested the existence of a pleuro-peritoneal communication. Tc 99m Sulphur colloid isotope scan was done. The scan showed clearance of colloid particles from peritoneal to pleural cavity. The patient was managed with albumin infusion, diuretics; and salt and fluid restriction. Pleural fluid drainage decreased with this intensive treatment.

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