figure a

Recently, 18F-FDG PET/CT has emerged as a valuable tool to evaluate infection as illustrated in this pediatric case [13]. A 9-year-old boy was hospitalized for low-grade fever and induration in the epigastric region. Previously, he had multiple cardiac surgeries for congenital heart disease including an epicardial dual chamber pacemaker implantation tunneled to the left upper abdominal quadrant. After an inconclusive ultrasound of the latter region, an 18F-FDG PET/CT was performed. Increased activity was found on both the non-attenuation-corrected (NAC) and CT attenuation-corrected (CTAC) images around the pacemaker (double arrow), along the tunnelized wires (thick arrow) and the intra-abdominal leads (thin arrows). No supradiaphragmatic extension was noted. The presence of pacemaker infection was confirmed during surgery [4, 5]. The 18F-FDG PET/CT confirmed the presence of infection on an emergency basis and helped surgical planning.