No abstract

Endogenous endophthalmitis is an uncommon infection of the internal tissues of the eye resulting from a bloodborne infection. We present the case of an 89-year-old man with Serratia marcescens urosepsis with multifocal end-organ infection on 18F-FDG PET/CT including aortitis, splenic abscess, septic arthritis, thoracolumbar discitis-osteomyelitis, and culture-confirmed bilateral endogenous endophthalmitis. Endophthalmitis-related intraconal ocular space uptake was clearly distinguishable from normal conal space extraocular muscle activity. Although sepsis responded to treatment, endophthalmitis led to complete vision loss. This case report presents PET/CT description of a rare and difficult-to-treat Serratia marcescens endogenous endophthalmitis, which usually has a poor visual outcome.

This interesting image illustrates an unusual case of inferior vena cava (IVC) syndrome from prostate cancer retroperitoneal adenopathy initially identified with skeletal scintigraphy. IVC syndrome is an infrequent occurrence resulting from extrinsic compression or intraluminal occlusion of the vessel. Whole-body planar skeletal scintigraphy showed a stable left sacroiliac metastasis and increased soft tissue uptake throughout the lower hemibody up to the lower chest level. Computed tomography (CT) demonstrated extrinsic compression of the IVC from metastatic retroperitoneal adenopathy. This represents a rare presentation of IVC syndrome in prostate cancer with characteristic appearance on skeletal scintigraphy of Fisherman's Wader's sign, that should prompt confirmatory anatomic imaging.

We report a case of a 6-year old girl with known type 3 Gaucher's Disease on enzyme replacement therapy who developed bilateral, symmetric osteolytic lesions in her humeri and femurs. While this manifestation of Gaucher's disease has been previously documented, it is an exceedingly rare variation. We observe that this patient shares 2 commonalities with 3 other patients reported in the literature to present with this phenotype. First, the patient's L444P/L444P genotype, present in approximately 11% of all Gaucher's patients, was also seen in these other patients. Second, like the other patients, this patient was treated with enzyme replacement therapy. It is unknown whether there is a correlation between these 2 independent variables and this rare phenotype, and further investigation may be warranted.

Secondary hemophagocytic lymphohistiocytosis (sHLH) is a rare disease with either an indolent or aggressive course. A 29-year-old male presented with fever, polyarthralgias, splenomegaly, retroperitoneal adenopathy, and laboratory findings consistent with Epstein–Barr-mediated sHLH. Consistent with a prior survival analysis by Kim et al ., splenic maximum standardized uptake value (SUV max ) >2.52 and bone marrow SUV max >3.13 on 18 F - fuorodeoxyglucose positron emission tomography/computed tomography ( 18 FDG-PET/CT) predicted an aggressive disease with poor treatment response. Despite optimal treatment, the patient rapidly progressed to death within 3 months of symptom onset. This case underscores the potential lethal nature of sHLH, and the evolving role of 18 FDG-PET/CT in predicting disease severity and treatment response.