Detection of Dressier syndrome following microinvasive mitral valve surgery by means of 18F-FDG PET/CTin 77-year-old woman with cardiac failure and fever of unknown origin
Abstract
Aim: To present a rare case report of a 77-year-old woman presenting with a cardiac failure and fever of unknown origin after micro-invasive mitral valve surgery. Subsequent 18F-FDG PET/CT revealed increased pericardialtracer uptake corresponding to Dressier syndrome.
Method: 77-year-old woman suffering from mitral regurgitation underwent micro-invasive mitral valve surgery. Two weeks later, she was admitted to the hospital due to cardiac failure.
During hospitalization, a fever of unknown origin developed and did not respond to antibiotics. However, no diagnosis was made after an intensive workup.
Due to recurrent fevers and an antibiotic treatment failure the whole body 18F-FDG PET/CT scan was performed. Results: The PET/CT examination revealed increased 18F-FDG uptake in the pericardial effusion (thickness: 14 mm) and in mediastinal lymph nodes.
Considering the previous micro-invasive mitralvalve surgery, the PET/CT findings were concluded as a Dressier syndrome with the reactive inflammatory changes in mediastinal lymph nodes. Inflammatory markers normalized after anti-inflammatory treatment (NSAID, corticosteroid and colchicine).
Conclusion: The 18F-FDG PET/CTimaging correctly detected Dressier syndrome following micro-invasive mitralvalve surgeryin a patient with fever of unknown origin. The examination improved a patient management and allowed a subsequent successful treatment.