Unusual synchronous liver and brain abscesses infected by rare Aerococcus viridians in a patient with pulmonary arteriovenous malformations on FDG PET/CT: A case report and literature review. Issue 49 (December 2017)

• Record Type: Journal Article
• Authors: Chen, Donghe; Dong, Mengjie; Zhao, Kui; Sun, Fang; Wang, Huatao; Liu, Zhengfeng
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 96:Issue 49(2017)
• Publication Date: 2017-12
• Subjects: abscesses -- Aerococcus viridans -- liver -- positron emission tomography/computed tomography -- pulmonary arteriovenous malformations; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000009048
• Languages: English
• ISSNs: 0025-7974

Abstract

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 ( 18 F-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 18 F-FDG PET/CT. 18 F-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 18 F-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 18 F-FDG PET/CT is suggested to identify possible accompanying abscesses in multiple organs for PAVMs patients.