Lack of Clinical Utility of Labeled White Blood Cell Scintigraphy in Patients With Fever of Unknown Origin.

Autor: Fisher RE; Department of Radiology, Baylor College of Medicine, Houston, Texas, USA.; Department of Radiology, Houston Methodist Hospital, Houston, Texas, USA., Drews AL; Section of Infectious Disease, Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA.; Houston Methodist Academic Institute, Houston, Texas, USA.; Weill Cornell Medical College, New York, New York, USA., Palmer EL; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2022 Jan 11; Vol. 9 (3), pp. ofac015. Date of Electronic Publication: 2022 Jan 11 (Print Publication: 2022).
DOI: 10.1093/ofid/ofac015
Abstrakt: Background: Labeled white blood cell scintigraphy (WBCS) has been used for over 40 years to localize an infection source in patients with fever of unknown origin (FUO). It continues to be in widespread use for such patients in modern times, despite the tremendous advances in modern radiological imaging and laboratory medicine.
Methods: We critically evaluated the clinical contribution of WBCS performed in 132 patients with FUO at 7 hospitals from mid-2015 to the end of 2019. For each patient, all radiographic and laboratory results and all electronic clinical notes were carefully evaluated as many days before and after the scan as necessary to arrive at a final diagnosis.
Results: Although 50 WBCS (38%) showed positive findings, the majority of these were false positive (FP). Of the 19 true-positive (TP) scans, most were already known or about to become known by tests already ordered at the time of the scan. Only 2 TP scans (1.5%) contributed to the final diagnosis, and these did so only indirectly. FP scans led to 7 unnecessary procedures.
Conclusions: In FUO patients for whom an infection source is not discovered following an appropriate radiographic and laboratory workup, WBCS is not a useful procedure.
(© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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