Unusual Case of Pseudomembranous Colitis Presenting as Fever of Unknown Origin Diagnosed by Tc-99m-HMPAO-labeled Leukocytes SPECT/CT.

The fever of unknown origin (FUO) represents a complex diagnostic challenge due to the wide range of etiologies that could cause it, including neoplastic, infectious, rheumatic/inflammatory, and miscellaneous disorders. Several nuclear medicine techniques have proven to be valuable tools for guiding etiologic diagnosis in the setting of FUO. One of these is technetium-99m (Tc-99m)-hexamethylpropylene amine oxime (HMPAO)-labeled leukocyte scintigraphy, which is a diagnosis method that allows in most cases the localization and evaluation of the extension of an occult infection. This paper presents an uncommon case of pseudomembranous colitis without diarrhea as etiology of FUO diagnosed by Tc-99m-HMPAO-labeled leukocytes.

Absolute quantification of myocardial uptake of 99mTc-DPD in patients with cardiac amyloidosis due to transthyretin deposits (ATTR).

PURPOSE: To determine the diagnostic contribution of the absolute quantification of the myocardial deposit of 99mTc-DPD in patients with cardiac amyloidosis due to transthyretin deposits (ATTR). MATERIALS AND METHODS: SPECT/CT was performed in 41 patients with positive scintigraphic results for ATTR cardiac amyloidosis. The patients were divided into two groups (Perugini grades 2 and 3) and the SUVmax at the level of the bone and both ventricles and the percentage of dose calculated in these areas were calculated. The Student's t-test was used to compare results and the area under the curve (AUC) was calculated to assess differential efficacy and establish discriminatory cut-off points between both groups of patients. RESULTS: Statistically significant differences were observed in all the study variables, with the exception of bone SUVmax. The differences with the greatest statistical power were observed in the variables SUVmaxRV and the percentage of dose in both ventricles (p < 0.001). The cut-off point obtained for the variable SUVmaxLV was 8.620 (sensitivity 87.9% and specificity 100%; AUC 0.966), while that of the variable SUVmaxRV was 6.195 (sensitivity 81.8% and specificity 100%; AUC 0.955). CONCLUSIONS: The absolute quantification of myocardial uptake of 99mTc-DPD in the SPECT/CT images of patients with suspected cardiac amyloidosis due to transthyretin deposits represents a new diagnostic tool that allows adequate classification of patients according to the Perugini visual grading scale.

[Epidemic outbreak of acute gastroenteritis due to norovirus with possible hydric origin]. / Brote epidémico de gastroenteritis aguda por norovirus con posible origen hídrico.

INTRODUCTION: To describe the clinical, microbiological and epidemiological investigations performed after an outbreak of acute gastroenteritis in a wedding. METHOD: A descriptive, case-control study was performed. An epidemiological survey (45 cases-28 controls) and inspection were carried out. RESULTS: Affected individuals had diarrhea and vomiting. Water and ice were contaminated. Norovirus was isolated in only one stool sample. Statistically significant differences in water consumption were found in bivariate analysis (p = 0.02; ORc = 10.6; 95% CI: 1.20-220.05) and multivariate analysis (p = 0.04; ORa = 8.93; 95% CI: 1.03-77.41). CONCLUSIONS: The clinical and epidemiological characteristics and laboratory results indicate that the most probable cause of the outbreak was norovirus.

Brote epidémico de gastroenteritis aguda por norovirus con posible origen hídrico / Epidemic outbreak of acute gastroenteritis due to norovirus with possible hydric origin

Describir la investigación clínica, epidemiológica y microbiológica de un brote de gastroenteritis aguda dado en una boda. Método. Estudio descriptivo y casos y controles. Se realizó encuesta epidemiológica (45 casos-28 controles) e inspección. Resultados. Diarrea y vómitos. Contaminación del agua e hielo. Sólo un coprocultivo positivo a norovirus. En análisis bivariante (p = 0,02; ORc = 10,6; IC 95%; 1,20-220,05) y multivariante (p = 0,04; ORa = 8,93; IC 95%: 1,03-77,41) existen diferencias estadísticamente significativas para el consumo de agua. Conclusiones. Las características clínicas, epidemiológicas y los resultados de laboratorio hacen altamente probable la etiología de este brote por norovirus (AU)

To describe the clinical, microbiological and epidemiological investigations performed after an outbreak of acute gastroenteritis in a wedding. Method. A descriptive, case-control study was performed. An epidemiological survey (45 cases-28 controls) and inspection were carried out. Results. Affected individuals had diarrhea and vomiting. Water and ice were contaminated. Norovirus was isolated in only one stool sample. Statistically significant differences in water consumption were found in bivariate analysis (p = 0.02; ORc = 10.6; 95% CI: 1.20-220.05) and multivariate analysis (p = 0.04; ORa = 8.93; 95% CI: 1.03-77.41). Conclusions. The clinical and epidemiological characteristics and laboratory results indicate that the most probable cause of the outbreak was norovirus (AU)