Using technetium-99m dimercaptosuccinic acid renal cortex scintigraphy to differentiate acute pyelonephritis from other causes of fever in patients with spinal cord injury

Objectives. To differentiate acute pyelonephritis (APN) from fever due to o ther sources in patients with spinal cord injury by using technetium-99m di mercaptosuccinic acid (DMSA) renal cortex scintigraphy (DMSA scan). Methods. A total of 24 patients with spinal cord injury were admitted with fever. DMSA scans were performed on all patients. The final determination o f the cause of the fever was based on the medical history, physical examina tion, laboratory evaluation, and imaging studies. Results. DMSA scan accurately diagnosed APN in 12 patients with inflammatio n on the DMSA scan. In 5 patients with scarred lesions on the DMSA scans an d in 7 patients with negative DMSA scan, the fever was attributed to other causes. The sensitivity and specificity of the DMSA scan for detecting APN were both 100%. Conclusions. The DMSA scan is a valuable adjunct in the evaluation of fever in patients with SCI. UROLOGY 55: 658-662, 2000. (C) 2000, Elsevier Scienc e Inc.