Elif İşleyen ÇOLAK, Seçkin BİLGİÇ, Eray ALPER
Cerrahpaşa Medical Journal - 2026;50(1):1-3
Infections related to cardiac assist devices pose significant diagnostic challenges, especially in patients with multiple implanted systems. A 45-year-old male was reported with both a left ventricular assist device (L VAD) and an implantable cardioverter defibrillator (ICD) evaluated for persistent driveline discharge despite extended antibiotic therapy . Serial cultures were negative for common L VAD pathogens, whereas Mycobacterium tuberculosis complex positivity in pleural fluid and a progressive purified protein derivative response supported concomitant tuberculosis infection. The scan revealed heterogeneous FDG uptake along the L VAD driveline, consistent with active infection, and homogeneous uptake around the pump, interpreted as sterile inflammation likely due to surgical adhesives. No abnormal uptake was observed around the ICD. These findings enabled accurate localization of the infection and prevented unnecessary device removal. Fluorodeoxyglucose (FDG) PET/CT proved valuable in differentiating infectious and noninfectious processes in coexisting cardiac devices, guiding focused surgical and antimicrobial management. This case underscores the growing clinical utility of FDG PET/CT in delineating complex cardiac device infections and its influence on tailored therapeutic decision-making in patients with mechanical circulatory support.
