Two weeks prior to presentation with sepsis, the patient inadvertently bumped a venous varicosity on his right ankle causing significant bleeding requiring emergency department presentation (managed with pressure and dressing). This was felt to represent the most likely source of bacterial ingress into the blood stream with demonstrated secondary infectious deposits in the grafted aortic arch and lung.

FDG PET is emerging as a useful diagnostic tool for investigating potential vascular graft infections with a recent case series of 34 patients demonstrating sensitivity and specificity of 96% and 86% respectively¹. Additionally, the series suggested an SUV_max cut off value of ≥3.8 to differentiate between infected and non-infected grafts (p <0.001)¹. Several studies have demonstrated sensitivity from 78-100% and specificity from 64-95%^2-6.

Further supporting the argument for FDG PET in vascular graft infections is the ability to detect sequelae of bacteremia and graft infection such as distant septic emboli.