Severe Obesity-Induced Computed Tomography Restrictions: A Case of Renal Infection With Bacteremia

TL;DR

A severely obese man could not initially undergo a CT scan due to weight limits, delaying diagnosis of a kidney infection until his weight decreased.

Contribution

Highlights the challenges of medical imaging for severely obese patients and suggests alternatives like MRI and high-capacity equipment.

Findings

A 224.8 kg patient could not undergo CT due to weight limits, delaying diagnosis of a renal infection.

MRI and high-capacity imaging equipment in nearby hospitals may serve as viable alternatives for severely obese patients.

Healthcare staff should be aware of equipment limits and prepared for patients exceeding them.

Abstract

Medical equipment has weight limits, but healthcare staff is often unaware of their exact specifications. However, as obesity rates rise globally and international mobility increases, healthcare providers will be required to treat more patients with extremely high body weight. We report a rare case of a 60-year-old, 224.8 kg man with diabetes who presented with a fever but could not initially undergo a computed tomography (CT) scan due to the scanner weight limit of 204 kg.The patient was diagnosed with a urinary tract infection (UTI), based on the detection of Proteus mirabilis from both blood and urine cultures and the fact that UTIs are the most common clinical manifestation of P. mirabilis. Treatment with antibiotics was performed without excluding conditions requiring surgical intervention among UTIs due to the inability to perform CT scans. On day 54 (post-discharge), his weight had decreased to 199 kg, allowing for a CT scan that revealed an enlarged left kidney and increased perirenal fatty tissue accumulation. The imaging findings, along with the gradual improvement in C-reactive protein levels and absence of fever, indicated a healed renal infection. This case underscores the impact of severe obesity on healthcare delivery. Healthcare staff should be familiar with actual weight or size limits for the available medical equipment. Contrary to assumptions, magnetic resonance imaging may be a viable alternative in some facilities for patients unsuitable for CT. Additionally, healthcare staff should be made aware of the availability of high-capacity imaging equipment in nearby hospitals. In conclusion, healthcare staff should be prepared in advance for cases in which patient weight exceeds medical equipment limits.

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