chiniofon and Focal-Infection

Fifteen children underwent scintigraphy with indium 111 (111In)-labeled white blood cells (WBC) for the detection of a local suppuration. The procedure generally contributed to a correct diagnosis. False negative results were observed in 5 children, but in two of them positive foci were also present. The missed lesions were 2 liver abscesses, 1 lung abscess, foci of osteomyelitis and 1 pericarditis. Two cases of chronic granulomatous disease are presented in which increased leucocyte accumulation was not observed in proven instances of infection.

Topics: Adolescent; Bacterial Infections; Child; False Negative Reactions; Focal Infection; Granulomatous Disease, Chronic; Humans; Hydroxyquinolines; Indium Radioisotopes; Leukocytes; Male; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging

Using a method of 111In-oxine granulocyte labelling in diluted plasma, we performed 162 scintigraphic studies in 159 patients with suspected non-osseous infection. We obtained a positive predictive value of 82%, and a negative predictive value of 97%, i.e. the method is very sensitive, albeit less specific. Sequential imaging showed around 50% of the scintigrams to turn positive at 30 min after the injection, the most rapid accumulation being seen in cases of superficial soft tissue infections and in pulmonary and pleural infections, cerebral abscesses showing a rather sluggish accretion of activity, urinary tract infections, abdominal abscesses and bowel inflammation accumulating activity at an intermediate rate. Our results indicate that the described method is sensitive, and that the sequential scintigraphic approach allows an early diagnosis in most cases, and facilitates the interpretation of delayed scans.

Topics: Focal Infection; Granulocytes; Humans; Hydroxyquinolines; Indium Radioisotopes; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Time Factors