PROMINENT SMALL-BOWEL GA-67 UPTAKE ASSOCIATED WITH YERSINIAL AND TUBERCULOUS ENTEROCOLITIS

The nuclear medicine evaluation of the immunocompromised patient with fever of unknown origin may include the use of either labeled leukocyt es or Ga-67 citrate, or both, in the search for an infectious focus. I n recent years, labeled leukocytes (In-111 or Tc-99m) seem to have bee n employed preferentially by some. This is especially the case when th e abdomen is a suspected site of involvement because of the normal col onic excretion of gallium that may complicate the interpretation of th is study. The authors present the case of an immunocompromised patient with the interesting scintigraphic pattern of diffuse large and small bowel uptake of gallium secondary to biopsy proven Yersinia and tuber culous enterocolitis. A review of the recent literature reveals only o ne other similar case in which Yersinial disease was detected by Ga-67 scintigraphy. The present case illustrates that gallium's avidity for the atypical, less pyogenic, opportunistic infections common in immun ocompromised patients justifies its continued use in such settings and , specifically, whenever tuberculosis is suspected.