%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Eldin, C.
%A Melenotte, C.
%A Million, M.
%A Cammilleri, S.
%A Sotto, A.
%A Elsendoorn, A.
%A Thuny, F.
%A Lepidi, H.
%A Roblot, F.
%A Weitten, T.
%A Assaad, S.
%A Bouaziz, A.
%A Chapuzet, C.
%A Gras, G.
%A Labussiere, A. S.
%A Landais, C.
%A Longuet, P.
%A Masseau, A.
%A Mundler, O.
%A Raoult, Didier
%T F-18-FDG PET/CT as a central tool in the shift from chronic Q fever to Coxiella burnetii persistent focalized infection : a consecutive case series
%D 2016
%L PAR00015082
%G ENG
%J Medicine
%@ 0025-7974
%K F-18-FDG PET ; CT ; Coxiella burnetii ; diagnosis ; focalized persistent ; infection ; Q fever
%K FRANCE
%M ISI:000384032900021
%N 34
%P e4287
%R 10.1097/md.0000000000004287
%U https://www.documentation.ird.fr/hor/PAR00015082
%V 95
%W Horizon (IRD)
%X Because Q fever is mostly diagnosed serologically, localizing a persistent focus of Coxiella burnetii infection can be challenging. F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) could be an interesting tool in this context.We performed a retrospective study on patients diagnosed with C burnetii infection, who had undergone F-18-FDG PET/CT between 2009 and 2015. When positive F-18-FDG PET/CT results were obtained, we tried to determine if it changed the previous diagnosis by discovering or confirming a suspected focus of C burnetii infection.One hundred sixty-seven patients benefited from F-18-FDG PET/CT. The most frequent clinical subgroup before F-18-FDG PET/CT was patients with no identified focus of infection, despite high IgG1 serological titers (34%). For 59% (n=99) of patients, a hypermetabolic focus was identified. For 62 patients (62.6%), the positive F-18-FDG PET/CT allowed the diagnosis to be changed. For 24 of them, (38.7%), a previously unsuspected focus of infection was discovered. Forty-two (42%) positive patients had more than 1 hypermetabolic focus. We observed 21 valvular foci, 34 vascular foci, and a high proportion of osteoarticular localizations (n=21). We also observed lymphadenitis (n=27), bone marrow hypermetabolism (n=11), and 9 pulmonary localizations.We confirmed that(18)F-FDG PET/CT is a central tool in the diagnosis of C burnetii focalized persistent infection. We proposed new diagnostic scores for 2 main clinical entities identified using F-18-FDG PET/CT: osteoarticular persistent infections and lymphadenitis.
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