1/12. Positively labeled white blood cell scan with eosinophilia and absence of infection.PURPOSE: The authors describe the variability of Tc-99m exametazime-labeled leukocyte distribution as a function of the relative frequency of white cell types in the labeled blood. MATERIALS AND methods: A 76-year-old man who was hospitalized with fever and possible postoperative osteomyelitis underwent scintigraphic imaging with Tc-99m exametazime-labeled leukocytes. RESULTS: The white cell scan excluded any discrete focus of infection and revealed diffuse involvement of the lymph nodes and skin. The pathologic diagnosis was angioimmunoblastic T-cell lymphoma. The atypical infiltrates seen on the white cell scan can be explained by the severe eosinophilic blood count on the day of leukocyte labeling (total leukocyte count: 8,100 cells/microl with 63% neutrophils, 8.9% lymphocytes, and 22.2% eosinophils). CONCLUSION: In the labeling of the leukocyte moiety, a higher presence of any leukocyte subpopulation will modify the biodistribution and thus the image interpretation.- - - - - - - - - - ranking = 1keywords = white blood cell, leukocytes, white blood, blood cell, white (Clic here for more details about this article) |
2/12. Unsuspected meningitis diagnosed by In-111 labeled leukocytes. A case report.Clinically unsuspected bacterial meningitis was found in a patient with fever of unknown origin. Blood and urine cultures were negative for growth. Chest radiography and abdominal CT were negative for infection. Triple-phase bone imaging was performed to rule out osteomyelitis from a gunshot wound. A left posterior iliac crest hot spot may have represented osteomyelitis, but In-111 labeled leukocyte imaging instead disclosed unsuspected meningitis. The CSF culture after the imaging was positive for enterobacter aerogenes.- - - - - - - - - - ranking = 0.23524388021947keywords = leukocytes (Clic here for more details about this article) |
3/12. Nonpustular psoriatic lesions detected by Tc-99m HMPAO labeled granulocytes.A patient with a fever of unknown origin was evaluated by abdominal SPECT using Tc-99m HMPAO labeled granulocytes and a triple detector camera. Although no abscesses were located, nonpustular psoriatic skin lesions were demonstrated incidentally on the reprojectional images. Psoriatic scales contain a chemotactic factor for leukocytes, and this is a likely explanation for the increased uptake of the radiotracer by psoriatic lesions.- - - - - - - - - - ranking = 0.058810970054867keywords = leukocytes (Clic here for more details about this article) |
4/12. vasculitis of the aortic arch and cardiac valves as the cause of relapsing fever of unknown origin in an elderly, white man.Here, we report the case of fever of unknown origin (FUO) in a 77-year-old white man. The patient presented with a 3-week history of fever (between 38.5 and 39 degrees C) and general malaise. These symptoms had occurred about five to seven times during the past 30 years, and despite repeated hospitalizations, no diagnosis was made. physical examination did not reveal any specific signs of infection nor did the patient fulfill the criteria for any rheumatic disease including vasculitides. Blood chemistry showed a greatly elevated c-reactive protein (CRP; 158.2 mg/l) and an erythrocyte sedimentation rate >100 mm, indicating an active inflammatory process, and leukocytes were significantly elevated (20,000/mul). Rheumatological parameters showed only nonspecific changes. Finally, a 2-[(18)F]-fluoro-2-deoxy-D: -glucose-positron emission tomography was performed, revealing a markedly enhanced glucose uptake in the ascending aorta and the cardiac valves, indicating vasculitis as the cause of FUO in this patient. Based on this finding, treatment was started with corticosteroids, and 2 days after the initiation of treatment, the patient had normal body temperature, and after 5 days, CRP values had returned to normal. After tapering and final complete removal of steroid treatment, the patient was still free of symptoms, hence no disease-modifying antirheumatic drug therapy was necessary.- - - - - - - - - - ranking = 0.067066037596884keywords = leukocytes, white (Clic here for more details about this article) |
5/12. Imaging infection with 18F-FDG-labeled leukocyte PET/CT: initial experience in 21 patients.The aim of this study was to assess the feasibility and the potential role of PET/CT with (18)F-FDG-labeled autologous leukocytes in the diagnosis and localization of infectious lesions. methods: Twenty-one consecutive patients with suspected or documented infection were prospectively evaluated with whole-body PET/CT 3 h after injection of autologous (18)F-FDG-labeled leukocytes. Two experienced nuclear medicine physicians who were unaware of the clinical end-diagnosis reviewed all PET/CT studies. A visual score (0-3)-according to uptake intensity-was used to assess studies. The results of PET/CT with (18)F-FDG-labeled white blood cell ((18)F-FDG-WBC) assessment were compared with histologic or biologic diagnosis in 15 patients and with clinical end-diagnosis after complete clinical work-up in 6 patients. RESULTS: Nine patients had fever of unknown etiology, 6 patients had documented infection but with unknown extension of the infectious disease, 4 patients had a documented infection with unfavorable evolution, and 2 patients had a documented infection with known extension. The best trade-off between sensitivity and specificity was obtained when a visual score of >or=2 was chosen to identify increased tracer uptake as infection. With this threshold, sensitivity, specificity, and accuracy were each 86% on a patient-per-patient basis and 91%, 85%, and 90% on a lesion-per-lesion basis. In this small group of patients, the absence of areas with increased WBC uptake on WBC PET/CT had a 100% negative predictive value. CONCLUSION: Hybrid (18)F-FDG-WBC PET/CT was found to have a high sensitivity and specificity for the diagnosis of infection. It located infectious lesions with a high precision. In this small series, absence of areas with increased uptake virtually ruled out the presence of infection. (18)F-FDG-WBC PET/CT for infection detection deserves further investigation in a larger prospective series.- - - - - - - - - - ranking = 0.35168093746472keywords = white blood cell, leukocytes, white blood, blood cell, white (Clic here for more details about this article) |
6/12. The role of indium-labelled leukocyte imaging in pyrexia of unknown origin.indium-111-labeled white blood cell scanning is often used in the investigation of pyrexia of unknown origin (PUO) to locate an otherwise occult source of sepsis. From a series of 166 white blood cell studies performed for sepsis, 28 cases of true PUO were identified and reviewed. The sensitivity was 60% and specificity 70%, with a positive predictive value of 38% and negative predictive value of 90%. Only 11% of studies revealed a pyogenic cause for PUO. These results are discussed and the potential role of gallium scanning in PUO is raised.- - - - - - - - - - ranking = 0.46811799470996keywords = white blood cell, white blood, blood cell, white (Clic here for more details about this article) |
7/12. Perforated acute appendicitis in a patient with AIDS/hiv infection: report of a case.We report herein the case of a 40-year-old man with AIDS who was admitted to hospital with severe abdominal pain, fever, and chills. He underwent an emergency laparotomy which revealed a perforated appendix with suppurative peritonitis. An appendectomy with peritoneal drainage was carried out, but the postoperative course was complicated by fever without leukocytosis; however, he gradually improved following treatment with intravenous antibiotics, granulocyte colony-stimulating factor (G-CSF) and immunoglobulins, and made a complete recovery. His postoperative course demonstrates the effectiveness of this treatment regimen for patients with AIDS complicated by infection without an increase in the white blood cell count (WBC).- - - - - - - - - - ranking = 0.23405899735498keywords = white blood cell, white blood, blood cell, white (Clic here for more details about this article) |
8/12. The role of scintigraphy in the evaluation of fever of unknown origin.nuclear medicine imaging techniques are an important adjunct to other currently used modalities in the evaluation of patients with fever of unknown origin. Bone scanning performed with technetium-labeled phosphonate agents may identify osteomyelitis when plain radiography fails and may disclose sites of joint inflammation or unsuspected osseous tumor metastasis. indium-labeled autologous leukocytes localize at sites of inflammation in the same manner as unlabeled leukocytes. gallium citrate accumulates in areas of inflammation and in some tumors, most notably lymphomas. In most cases, scintigraphy is best used to determine the location of a lesion rather than to specifically identify the pathologic process.- - - - - - - - - - ranking = 0.11762194010973keywords = leukocytes (Clic here for more details about this article) |
9/12. Persistent fever due to occult dental infection: case report and review.Dental sepsis is one potential cause of persistent fever that can escape detection. A patient with febrile episodes due to an occult tooth abscess of 2 years' duration is described. A search of the English-language literature revealed 20 other cases of fever of obscure origin arising from dental sources. This diagnosis may be suggested by repeated questioning of the patient about his or her medical history, repeated physical examination, an elevated erythrocyte sedimentation rate, or a history of failure to respond to antibiotic therapy. Dental infection is unlikely in patients who have a white blood cell count of > 11 x 10(9)/L, a temperature of > 39.5 degrees C, or positive blood cultures. The diagnosis may be made by repeated focused clinical examination, dental roentgenography, or radiolabeled leukocyte scintigraphy. Detection of dental sepsis is worthwhile since the febrile condition can be cured in all instances by tooth extraction and abscess drainage, with or without concurrent antibiotic therapy.- - - - - - - - - - ranking = 0.23405899735498keywords = white blood cell, white blood, blood cell, white (Clic here for more details about this article) |
10/12. technetium-99m HMPAO labeled leukocytes as the primary diagnostic tool in a case of brain abscess.The authors present a case in which Tc-99m HMPAO labeled autologous leukocytes were used to demonstrate a brain abscess in a patient undergoing evaluation for fever of unknown origin. The abscess was demonstrated on both 1-hour and 24-hour images. The positive 1-hour image led to CT and MRI studies, which are included for correlation. In addition to its previously identified role as a secondary diagnostic test in the differentiation of tumor and abscess, the authors propose that Tc-99m HMPAO is useful as a primary diagnostic tool in the identification of brain abscess. Furthermore, the authors suggest that Tc-99m HMPAO is preferable to In-111 labeled leukocytes because of its better resolution and earlier imaging characteristics.- - - - - - - - - - ranking = 0.3528658203292keywords = leukocytes (Clic here for more details about this article) |
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