Fluorine-18-FDG-PET/CT in Cytomegalovirus Colitis

Abstract

with 25 of took a which reveal no The patient is diabetic on with acute kidney injury, pre-treatment investigations reveal a HB of 7.2, TLC 11,600, S. Cr – 3.60 mg/dl, BUN – 118, and Na 124, nearly normal all other relevant investigations. Blood analysis for widal, HBsAg, HCV, blood Further and colonic Biopsy from a cecal revealed a diagnosis of cytomegalovirus (CMV) colitis with the presence of CMV DNA on IHC. IgM CMV ABSTRACT Cytomegalovirus (CMV) colitis as a cause of pyrexia of unknown origin (PUO) is rarely document on fluorodeoxyglucose-positron-emission-tomography/computed-tomography (FDG-PET/CT) scan in Indian literature. The typical pet images with intense FDG uptake in large bowel are rare to see and are exclusively ruled out the cause of pathology. Only few cases reported with FDG-PET/CT in CMV colitis in world literature. We present a case of 55-year-old female with PUO diagnosed as an acute CMV colitis. A fluorine-18-FDG-PET/CT scan (F-18-FDG-PET/CT scan) was performed to diagnose the infective focus which reveals symmetrical intense increased pathological FDG uptake in entire large bowel from cecum to sigmoid colon with corresponding CT images showed mildly edematous bowel wall. Further colonoscopy revealed edematous and ulcerated colonic mucosa. Biopsy from small cecal ulcer revealed a diagnosis of CMV colitis with the presence of CMV DNA in IHC. CMV antigenemia in blood is also confirmed on evaluation which responded to antiherpes treatment ganciclovir. From these findings, this case highlights a typical pattern of FDG uptake in F-18-FDG-PET/CT scan. Fused CT and PET CT images in axial, coronal and sagittal reconstructions revealing diffuse right colonic mural thickening with