Unusual synchronous liver and brain abscesses infected by rare Aerococcus viridians in a patient with pulmonary arteriovenous malformations on FDG PET/CT

Abstract

Rationale:Pulmonary arteriovenous malformations (PAVMs) complicated with multiple organ abscesses is an uncommon manifestation. Because of the low incidence of the disease, F-18 fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) imaging studies for PAVMs complicated with multiple organ abscesses are scarce.Patient concerns:We report a case of a 54-year-old man presenting with PAVMs complicated with synchronous multiple organ abscesses founded by 18F-FDG PET/CT. 18F-FDG PET/CT revealed tortuous stripes and mass opacities with no significant FDG uptake in the left upper lung lobe. However, hypermetabolic lesions located in the anterior inferior segment of right hepatic lobe [with maximum standardized uptake value (SUVmax) of 10.7], and in the right basal ganglia with SUVmax of 14.1 were found by 18F-FDG PET/CT.Diagnoses:A diagnosis of synchronous liver and brain abscesses infected by rare Aerococcus viridans was determined by tissue culture.Interventions:Vancomycin was provided intravenously, and oral linezolidate tablets were prescribed for anti-inflammatory treatment for 1 month. Liver and head magnetic resonance imaging was performed during the follow-up.Outcomes:The lesion in the right basal ganglia was reduced, and the lesion in the right liver had disappeared, indicating the lesions were abscesses.Lessons:The present case indicated that the possibility of abscesses should be considered with patients with PAVMs, and whole-body 18F-FDG PET/CT is suggested to identify possible accompanying abscesses in multiple organs for PAVMs patients.

Concomitant Liver and Brain Abscesses Caused by Parvimonas Micra

“…Concomitant liver and brain abscesses are uncommon, but according to previous articles on the subject, long-term (1-4 months) antibiotic treatment results in effective resolution and has a favorable prognosis. [15][16][17][18] Poor prognostic factors for brain abscess included a low mean GCS score at presentation, and the presence of septic shock and neck stiffness. 19 Our patient had a low GCS score (9) and septic shock at presentation and unfortunately a poor outcome.…”

18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging features in patients with non-tuberculous mycobacterial infection

“…Unlike traditional imaging, 18 F-FDG PET/CT detects functional or metabolic alterations in in ammatory cell activity prior to morphological abnormalities, regardless of post-in ammatory scar [19,20] . Another advantage of 18 F-FDG PET/CT is the ability to assess infection throughout the body [21,22] . The most commonly markers used to assess FDG-uptake levels are SUV max and SUR.…”

Unusual disseminated Talaromyces marneffei infection mimicking lymphoma in a non-immunosuppressed patient in East China: a case report and review of the literature

“…Integrated FDG PET/CT is a wide imaging technique used in the evaluation of diverse oncological indications. It is being increasingly recognized that FDG PET/CT has clinical applications beyond the remit of cancer imaging with addition value in fields of non-oncological conditions, including suspected infection and inflammation [ 17 , 18 ]. Early performing FDG PET/CT imaging has been shown to more accurately detect clinically occult neoplasm or sources of the fever and identify additional disease sites compared to conventional imaging, and guide appropriate treatment [ 19 – 21 ].…”