Table 2 Infection focus found on FDG-PET/CT and treatment modification

Pneumonia

5

4

1

Patient 1. A diagnostic puncture of a PET-positive septic embolus at the left acetabulum was performed. Treatment with liposomal amphotericin B and voriconazole was continued

Patient 2: Treatment with caspofungin was continued until repeat FDG-PET/CT showed no signs of pulmonary infection 6 weeks later

Patient 3: This patient already received vancomycin, but due to pathologic pulmonary FDG uptake cotrimoxazole was added for better pulmonary penetration

Patient 4: This patient already received ceftazidime, but after FDG-PET/CT showed hospital-acquired pneumonia tobramycin was additionally started

Septic arthritis

4

1

3

Patient 1: Surgical washout of the left hip was performed, flucloxacillin dosage of 12 g/24 h was increased to 16 g/24 h intravenously

Patient 2: Surgical washout of the right shoulder and left hip was performed. Treatment with flucloxacillin 12 g/24 h was continued

Aspergilloma

1

1

0

Patient 1: Treatment with Amphotericin B and voriconazole was started

Infection obturator internus

1^a

1^a

0

Patient 1. The obturator internus muscle of the right leg was surgically explored and washed out

Endocarditis

1

0

1

No changes in clinical management

Generalized candidiasis

1

1

0

Patient 1. A diagnostic puncture of a PET-positive lesion of the thyroid gland was performed. Treatment with liposomal amphotericin B and voriconazole was continued

Sinusitis

1

1

0

Patient 1: After FDG-PET/CT saline irrigation (of the maxillary sinus) was started 4 to 6 times per day. The patient already received vancomycin and ceftriaxone

Parotitis

1

0

1

No changes in clinical management

Sclerosing peritonitis

1

0

1

Patient 1: Because no other infection focus than sclerosing peritonitis was found on FDG-PET/CT, relaparotomy with abdominal washout was performed

Abdominal abscess

1

0

1

No changes in clinical management

Infected hepatic fluid collection

1

1

0

Patient 1: the fluid collection was drained. Flucloxacilline 12 g/24 h intravenously was supposed to be continued for 6 weeks instead of 2 weeks. However, the patient died after 4 weeks of treatment

Infected venous access port

1

1

0

Patient 1. Treatment with flucloxacillin 6.7 g/24 h (pediatric dose) was prolonged to 6 weeks because of multiple septic emboli. Clindamycin was added for better pulmonary penetration to treat the pulmonary septic emboli

Septic thrombophlebitis

1

0

1

No changes in clinical management

Pancreatitis

1

0

1

Patient 1: After surgical removal of a pancreatic pseudocyst due to trauma, FDG-PET/CT confirmed pancreatic infection for which relaparotomy and abdominal washout were performed

No focus found

9^b

n/a

n/a

Patient 1. In one patient, no focus was found but increased FDG uptake of the pancreas was noticed. For this reason, FDG-PET/CT was repeated 6 weeks later, which showed normalized pancreatic uptake