Grant: Project Grant

Infection of heart valve, called infective endocarditis (IE), occurs when bacteria circulating in the bloodstream attach and multiply on a cardiac valve. This infection can lead to serious complications, including destruction of the valve, spreading of the infection, and in some cases, death. Symptoms of patients with IE are highly variable, making the diagnosis challenging. To help physicians, a set of criteria called the Duke criteria were developed. The Duke criteria are composed of 2 major and 5 minor criteria representing various symptoms and examination findings. Based on the number of major and minor criteria, patients are classified into 3 groups: definite IE, possible IE, and IE excluded. In patients classified with possible IE, infection is neither confirmed nor excluded and further investigations are required. Approximately a third of patients are classified as having possible IE. In those cases, there are often delays in diagnosis and initiation of treatment, which leads to more disease progression, more complications, and death in some cases. Positron emission tomography (PET scan) is an imaging tool that allow us to see diseases with a high degree of precision. PET scans were initially used for cancer detection and have since become extremely useful for imaging many infectious diseases. To image infections with a PET scanner, a tracer called FDG is injected in a patient vein and pictures are then taken with the PET scanner. FDG is a radioactive sugar that accumulated in the cells found at infection sites. Whether PET scan can improve detection of IE on patients without valve prosthesis remains unknown. The purpose of this proposal is to assess if PET scan can improve the Duke criteria performance by reducing the number of patients classified with possible IE. The results of the proposed research could have a direct and immediate impact on the management of patients with suspected IE.