Role of Gallium-67 scintigraphy in the evaluation of occult sepsis in the medical ICU

• Published in: Internal and emergency medicine Vol. 7; no. 1; pp. 53 - 58
• Main Authors: Chen, Wei-Chun, Tsai, Kuen-Daw, Chen, Chia-Hung, Lin, Ming-Shian, Chen, Chuan-Mu, Shih, Chuen-Ming, Chen, Wei
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.02.2012; Springer Nature B.V
• Subjects: Abscesses; Adult; Age Distribution; Aged; Aged, 80 and over; Antibiotics; Arthritis; Blood Chemical Analysis; Cellulitis; Chi-Square Distribution; cholecystitis; Cohort Studies; Data processing; Decubitus ulcers; Drainage; EM - Original; Endocarditis; Female; Fever; Follow-Up Studies; Gallium Isotopes; Hospital Mortality; Hospitals; Humans; imaging; Incidence; Infection; Intensive Care Units; Internal Medicine; Joint diseases; Leg; Lung; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Mycobacterium; Neck; Osteomyelitis; Pneumonia; psoas muscle; Radionuclide Imaging; Retrospective Studies; Risk Assessment; Scintigraphy; Sepsis; Sepsis - diagnosis; Sepsis - diagnostic imaging; Sepsis - epidemiology; Severity of Illness Index; Sex Distribution; Soft tissues; Survival Analysis; Tuberculosis; Young Adult; Sepsis; Gallium scan; Intensive care; Fever
• ISSN: 1828-0447; 1970-9366; 1970-9366
• DOI: 10.1007/s11739-011-0739-8

Patients in intensive care units (ICUs) frequently have multiple infections or persistent fever despite management. The aim of this study was to evaluate the diagnostic contribution of gallium-67 scintigraphy in ICU patients with suspected occult sepsis. One hundred and seventeen patients (>18 years) who had undergone gallium-67 scintigraphy in the ICU of our medical center over a 3-year period were retrospectively reviewed and analyzed. Patients were categorized into Group 1 ( n  = 84), those with a known infectious source, but who still had persistent fever or sepsis despite antibiotic treatment or abscess drainage; or Group 2 ( n  = 33), those without an evident infectious source after clinical, physical, and imaging studies. Among the 117 patients, 19 (16.2%) had a new diagnosis. In Group 1, 12 patients (14%) had a new infection, including pneumonia (4 patients), bed sore infection (2 patients), pulmonary tuberculosis (2 patients), leg cellulitis (1 patient), psoas muscle abscess (1 patient), osteomyelitis (1 patient), and infective endocarditis (1 patient). In Group 2, seven patients (21.2%) had a new infectious source, including septic arthritis (3 patients), osteomyelitis (2 patients), neck abscess (1 patient), and cholecystitis (1 patient). Significant differences were not observed between patients with positive and negative findings on gallium-67 scintigraphy in characteristics, underlying diseases, laboratory data, and outcomes. Gallium-67 scintigraphy helped to detect new or additional infectious sites, particularly bone, joint, and soft tissues. However, differences in hospital stay and mortality were not observed between patients with positive and negative findings.