Role of Gallium-67 scintigraphy in the evaluation of occult sepsis in the medical ICU |
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Authors: | Wei-Chun Chen Kuen-Daw Tsai Chia-Hung Chen Ming-Shian Lin Chuan-Mu Chen Chuen-Ming Shih Wei Chen |
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Institution: | (1) Division of Pulmonary and Critical Care Medicine, China Medical University Beigang Hospital, Yunlin, Taiwan;(2) Division of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung, Taiwan;(3) Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, #539 Jhongsiao Rd, Chia-Yi, Taiwan;(4) Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan;(5) Department of Respiratory Therapy, China Medical University, Taichung, Taiwan; |
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Abstract: | Patients in intensive care units (ICUs) frequently have multiple infections or persistent fever despite management. The aim
of this study was to evaluate the diagnostic contribution of gallium-67 scintigraphy in ICU patients with suspected occult
sepsis. One hundred and seventeen patients (>18 years) who had undergone gallium-67 scintigraphy in the ICU of our medical
center over a 3-year period were retrospectively reviewed and analyzed. Patients were categorized into Group 1 (n = 84), those with a known infectious source, but who still had persistent fever or sepsis despite antibiotic treatment or
abscess drainage; or Group 2 (n = 33), those without an evident infectious source after clinical, physical, and imaging studies. Among the 117 patients,
19 (16.2%) had a new diagnosis. In Group 1, 12 patients (14%) had a new infection, including pneumonia (4 patients), bed sore
infection (2 patients), pulmonary tuberculosis (2 patients), leg cellulitis (1 patient), psoas muscle abscess (1 patient),
osteomyelitis (1 patient), and infective endocarditis (1 patient). In Group 2, seven patients (21.2%) had a new infectious
source, including septic arthritis (3 patients), osteomyelitis (2 patients), neck abscess (1 patient), and cholecystitis (1
patient). Significant differences were not observed between patients with positive and negative findings on gallium-67 scintigraphy
in characteristics, underlying diseases, laboratory data, and outcomes. Gallium-67 scintigraphy helped to detect new or additional
infectious sites, particularly bone, joint, and soft tissues. However, differences in hospital stay and mortality were not
observed between patients with positive and negative findings. |
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