Therapy monitoring in aspergillosis using F-18FDG positron emission tomography

Chronic granulomatous disease is a primary immunodeficiency disorder that involves the malfunction or absence of the nicotinamide adenine dinucleotide phosphate oxidase in the phagocytic cells. This deficiency causes a defective microbiologic defense. Consecutive recurrent bacterial or fungal infections, especially aspergillosis, are life threatening. Therefore, early diagnosis of infections, aggressive therapy, and lifelong antibiotic prophylaxis are crucial for patients who are affected. The authors describe 3-month-old enzygotic twins, both with pulmonary aspergillosis within the context of chronic granulomatous disease. Positron emission tomography with fluorine-18 fluorodeoxyglucose (F-18 FDG PET) was used for staging and therapy monitoring during antimycotic treatment and proved feasible even within the first year of life.