GALLIUM SCANNING IN CHILDREN WITH FEVER OF UNKNOWN ORIGIN

Scintigraphy with Gallium 67 is frequently used in the evaluation of c hildren with fever of unknown origin (FUO). Its usefulness in this set ting, however, has not been definitely established. We reviewed the cl inical records and imaging studies of 30 children with FUO who had Gal lium scans. We defined FUO as a febrile illness of greater than two we eks duration which remained undiagnosed after initial clinical, labora tory and radiographic evaluation. 4 of 30 children had positive Galliu m scans. Of 25 children with only systemic signs and symptoms in addit ion to fever, 1 had a positive scan. Of 5 children with more focal com plaints, 3 had positive studies: all had localized infections which ha d remained occult despite imaging with other modalities. We conclude t hat in most children with FUO, who have only systemic complaints, Gall ium scanning is rarely useful. It may be very helpful, however, when t here is a suspicion of localized infection, even if other imaging stud ies are negative.