Journal article
Colonic localization of labeled leukocytes in critically ill patients: scintigraphic detection of pseudomembranous colitis
Clinical nuclear medicine, Vol.20(2), pp.99-106
1995
DOI: 10.1097/00003072-199502000-00001
PMID: 7720321
Abstract
This study assesses the causes of colonic localization of labeled white blood cells (WBCs) in critically ill patients who had undergone leukocyte scintigraphy for suspected infection. Forty-two patients showed abdominal or pelvic WBC localization; 20 of these had a pattern of colonic localization, and some also showed a pattern of small bowel activity. Eight of the 20 patients had documented gastrointestinal bleeding. White blood cell scintigraphy in these eight patients showed a pattern of multifocal and/or regional bowel activity that changed in intensity and location from early (3- 5-hour) to delayed (18-28-hour) images. In contrast, 5 of the 6 patients with documented pseudomembranous colitis (PMC) showed intense WBC localization involving most of the colon. In 3 of these 5 patients, early and delayed images were acquired and showed a relatively constant pattern of WBC localization. The sixth PMC patient had been treated with vancomycin before leukocyte scintigraphy and showed minimal distal small bowel activity on early images and only mild regional colonic activity on delayed images. As in the patients with gastrointestinal bleeding, the remaining six patients showed either focal or regional activity of variable intensity that changed over time. In critically III patients, gastrointestinal bleeding and PMC accounted for 14 of the 20 patients in which labeled leukocyte scintigraphy exhibited colonic activity. A pattern of diffuse, intense colonic radiotracer activity which persists from early to delayed imaging strongly suggests the presence of PMC in this patient population. Diagnostic tests to confirm the presence of Clostridium difficile should be undertaken in critically ill patients in whom leukocyte scintigraphy shows diffuse WBC localization involving most of the colon.
Details
- Title: Subtitle
- Colonic localization of labeled leukocytes in critically ill patients: scintigraphic detection of pseudomembranous colitis
- Creators
- M. A Nathan - University of IowaJ. E Seabold - University of IowaB. P Brown - University of IowaD. L Bushnell - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Clinical nuclear medicine, Vol.20(2), pp.99-106
- Publisher
- Lippincott
- DOI
- 10.1097/00003072-199502000-00001
- PMID
- 7720321
- ISSN
- 0363-9762
- eISSN
- 1536-0229
- Language
- English
- Date published
- 1995
- Academic Unit
- Radiology
- Record Identifier
- 9984318716602771
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