FDG PET/CT in Aortic Valve Bioprosthesis Infection

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A 62-year-old man presented with persistent fever, weakness, and retrosternal pain 3 years after aortic valve bioprosthesis (AVR). His white blood cell count was 11,000/μL and C-reactive protein was 13.6 mg/dL. Consecutive blood cultures isolated Staphylococcus epidermidis and capitis. Transesophageal echocardiography demonstrated small aortic valve prosthesis vegetation. 18F-FDG PET/CT revealed prominent AVR activity, SUVmax = 12.2. He was treated with daptomycin, meropenem, and gentamicin for 1 month and followed by daptomycin and carbapenem for 3 months. Follow-up 18F-FDG PET/CT at 6 months demonstrated complete clearing of AVR activity associated with full asymptomatic recovery.

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