18F-FDG PET/CT in the diagnosis of occult bacterial infections in children

The role of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) in the diagnosis and follow-up of infectious diseases has expanded recently. The aim of this report is to communicate our experience regarding its role in the diagnosis and management of occult bacterial infections in children. We present three pediatric patients with occult bacterial infections and negative conventional studies in whom F-18-FDG PET/CT had a significant effect on clinical management. One patient had streptococcal endocarditis and prolonged fever. F-18-FDG PET/CT identified pneumonia and osteomyelitis, and was also used to monitor therapeutic response. Other patient had a cerebrospinal shunt fluid infection. F-18-FDG PET/CT was used to determine the exact localization of infection and establish the best surgical approach. The last patient had fever of unknown origin. F-18-FDG PET/CT identified splenic abscesses, which were surgically treated. Conclusion: F-18-FDG PET/CT should be considered as a useful diagnostic tool in children with suspected bacterial infections, if conventional diagnostic imaging techniques have failed to yield positive results.