Ces radiol. 2022, 76(2):139-142 | DOI: 10.55095/CesRadiol2022/018

Detection of Dressler syndrome following microinvasive mitral valve surgery by means of 18F-FDG PET/CT in 77-year-old woman with cardiac failure and fever of unknown originOriginal article

Jiří Doležal1, Jiří Vaňásek2, Jiří Dokoupil3, Eva Krčálová1, Elen Urbanová1
1 Oddělení nukleární medicíny LF UK a FN, Hradec Králové
2 Radiologická klinika LF UK a FN, Hradec Králové
3 I. interní kardioangiologická klinika LF UK a FN, Hradec Králové

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 pericardial tracer uptake corresponding to Dressler 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 mitral valve surgery, the PET/CT findings were concluded as a Dressler 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/CT imaging correctly detected Dressler syndrome following micro-invasive mitral valve surgery in a patient with fever of unknown origin. The examination improved a patient management and allowed a subsequent successful treatment.

Keywords: Dressler syndrome, fever unknown origin, PET/CT, 18F-FDG
Grants and funding:

Podpořeno MZ ČR - RVO (FNHK, 00179906).

Accepted: March 1, 2022; Published: June 1, 2022  Show citation

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Doležal J, Vaňásek J, Dokoupil J, Krčálová E, Urbanová E. Detection of Dressler syndrome following microinvasive mitral valve surgery by means of 18F-FDG PET/CT in 77-year-old woman with cardiac failure and fever of unknown origin. Ces radiol. 2022;76(2):139-142. doi: 10.55095/CesRadiol2022/018.
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