Indian Journal of Nuclear Medicine

The most significant clinical aspect of pyrexia of unknown origin (PUO) in pediatric population is the striking contrast between the child's general appearance and febrile course. In spite of a persistently elevated temperature, the patient is usually alert and playful and may be asymptomatic. The use of radiolabelled antibiotics presents a promising approach for the precise diagnosis and detection of infectious lesions, because they specifically bind to the bacterial component. Therefore, the present study was carried out to locate the infection site if any in the children suffering with (PUO), using ^99mTc-ciprofloxacin (Diagnobact, single vial preparation provided by INMAS, DRDO, Delhi, India) scintigraphy. ^99mTc-ciprolfloxacin scintigraphy was performed in 10 pediatric (5M:5F, mean age 6.2 yrs, range 6 mon-13yrs) patients. A written and informed consent was obtained from the study subjects or from one of the parents. All the patients underwent whole body imaging at 10 minutes, 1 h, 4 h & 24h after the i.v. administration of 37–370 MBq radioactivity of ^99m Tc-ciprofloxacin (Diagnobact). The images were acquired on a dual head Gamma camera (Varicam, GE), peaked at 140 Kev ± 15% window using LEHR parallel hole collimator. The SPECT images were acquired at 4-h at the site of suspicion of abnormal focus of the radiotracer concentration. The sensitivity, specificity, PPV and NPV of the present study was evaluated to be 75%, 100%, 100% and 50% respectively. It is thus concluded that ^99mTc-ciprofloxacin scintigraphy is an accurate and non-invasive diagnostic modality to localize site of active bacterial infection in asymptomatic pediatric patients having PUO.