Is there a role for 99mTc-HMPAO leucocyte scintigraphy in infective endocarditis?

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dc.contributor.authorEllmann A.
dc.contributor.authorRubow S.
dc.contributor.authorErlank P.
dc.contributor.authorReuter H.
dc.date.accessioned2011-05-15T16:15:54Z
dc.date.available2011-05-15T16:15:54Z
dc.date.issued2003
dc.description.abstractInfective endocarditis is an important disease in developing countries. A combination of clinical findings, typical organisms cultured from blood, and specific echocardiographic features are used to establish the diagnosis. The diagnosis is often difficult because cultures are not always positive and transthoracic echocardiography lacks sensitivity and specificity, leading to delayed treatment or inappropriate therapy. As 99mTc-HMPAO-labelled leucocyte scintigraphy is used routinely to evaluate patients with suspected infectious processes, it was postulated that this technique might also aid in the diagnosis of infective endocarditis in patients with underlying chronic rheumatic heart disease or other valvular disease. Six patients were referred for 99mTc-HMPAO-labelled leucocyte scintigraphy. The white blood cells were labelled according to standard procedures. Whole-body planar imaging and single photon emission tomography of the chest area, with imaging at 30 minutes, 3 hours and 24 hours after the administration of the labelled leucocytes, were performed on all patients. All the scintigrams were negative. The reasons for the negative findings are not entirely clear, but probably reflect the pathological nature of vegetations, which consist mainly of masses of fibrin, clotted platelets and blood cell debris, containing the causative organisms. Leucocytes do not play a major role in the pathological process. Although only six patients were studied, it appears that 99mTc-HMPAO leucocyte scintigraphy is of little value in the evaluation of patients with infective endocarditis. A study after the administration of radiolabelled antibiotics may be of greater value and should be considered in these patients.
dc.description.versionArticle
dc.identifier.citationCardiovascular Journal of South Africa
dc.identifier.citation14
dc.identifier.citation4
dc.identifier.issn10159657
dc.identifier.urihttp://hdl.handle.net/10019.1/13540
dc.subjectantibiotic agent
dc.subjectfibrin
dc.subjecthexamethylpropylene amine oxime technetium tc 99m
dc.subjectleukocyte hexamethylpropylene amine oxime technetium tc 99m
dc.subjectunclassified drug
dc.subjectdiagnostic agent
dc.subjectadult
dc.subjectarticle
dc.subjectbacterial endocarditis
dc.subjectblood culture
dc.subjectblood pool scintiscanning
dc.subjectcell labeling
dc.subjectclinical article
dc.subjectclinical feature
dc.subjectdiagnostic value
dc.subjectfemale
dc.subjecthuman
dc.subjectisotope labeling
dc.subjectleukocyte
dc.subjectmale
dc.subjectrheumatic heart disease
dc.subjectsingle photon emission computer tomography
dc.subjectthrombocyte aggregation
dc.subjecttransthoracic echocardiography
dc.subjectvalvular heart disease
dc.subjectwhole body scintiscanning
dc.subjectcomparative study
dc.subjectechography
dc.subjectepidemiology
dc.subjecthospitalization
dc.subjectmethodology
dc.subjectscintiscanning
dc.subjectsensitivity and specificity
dc.subjecttransesophageal echocardiography
dc.subjectAdult
dc.subjectEchocardiography, Transesophageal
dc.subjectEndocarditis, Bacterial
dc.subjectFemale
dc.subjectHumans
dc.subjectLeukocytes
dc.subjectMale
dc.subjectSampling Studies
dc.subjectSensitivity and Specificity
dc.subjectSeverity of Illness Index
dc.subjectTechnetium Tc 99m Exametazime
dc.subjectTomography, Emission-Computed, Single-Photon
dc.titleIs there a role for 99mTc-HMPAO leucocyte scintigraphy in infective endocarditis?
dc.typeArticle
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