FDG PET/CT in the Localization of Cardiac Device Infections: Discriminating Between Left Ventricular Assist Device and Implantable Cardioverter Defibrillator Infection


İşleyen Çolak E., Bilgiç S., Alper E.

Cerrahpaşa Medical Journal, cilt.50, sa.1, ss.1-3, 2026 (TRDizin)

  • Yayın Türü: Makale / Vaka Takdimi
  • Cilt numarası: 50 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.5152/cjm.2026.25095
  • Dergi Adı: Cerrahpaşa Medical Journal
  • Derginin Tarandığı İndeksler: TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.1-3
  • Bursa Uludağ Üniversitesi Adresli: Evet

Özet

Infections  related  to  cardiac  assist  devices  pose  significant  diagnostic  challenges,  especially  in  patients  with multiple implanted systems. A 45-year-old male was reported with both a left ventricular assist device (LVAD)  and  an  implantable  cardioverter  defibrillator  (ICD)  evaluated  for  persistent  driveline  discharge  despite  extended  antibiotic  therapy.  Serial  cultures  were  negative  for  common  LVAD  pathogens,  whereas  Mycobacterium tuberculosis complex positivity in pleural fluid and a progressive purified protein deriva-tive response supported concomitant tuberculosis infection. The scan revealed heterogeneous FDG uptake along  the  LVAD  driveline,  consistent  with  active  infection,  and  homogeneous  uptake  around  the  pump,  interpreted  as  sterile  inflammation  likely  due  to  surgical  adhesives.  No  abnormal  uptake  was  observed  around the ICD. These findings enabled accurate localization of the infection and prevented unnecessary device removal. Fluorodeoxyglucose (FDG) PET/CT proved valuable in differentiating infectious and nonin-fectious processes in coexisting cardiac devices, guiding focused surgical and antimicrobial management. This  case  underscores  the  growing  clinical  utility  of  FDG  PET/CT  in  delineating  complex  cardiac  device  infections and its influence on tailored therapeutic decision-making in patients with mechanical circulatory support.

Keywords: Cardiac device infection, device-related endocarditis, driveline, FDG PET/CT, LVAD infection