A case of tuberculous peritonitis monitored by gallium-67 scintigraphy

An 18-year-old man was admitted to our hospital for further examination of fever of unknown origin and ascites. Ga-67 scintigraphy revealed diffuse in creased uptake throughout the abdomen. He was diagnosed with tuberculous pe ritonitis and began the treatment for tuberculosis (rifampicin, 450 mg/day orally and isoniazid, 300 mg/day orally, and 0.75 g of streptomycin by intr amuscular injection 2 times a week). One year after starting the treatment, Ga-67 scintigraphy revealed accumulation of radioactivity in the upper abd omen, but the diffuse accumulation in the abdomen decreased. A specimen obt ained by tumor biopsy under ultrasonic guidance revealed a tuberculous gran uloma. Percutaneous injection was performed in the tumor with 1.0 g of stre ptomycin. On Ga-67 scintigraphy performed 2 weeks after the injection of st reptomycin, the accumulation of radioactivity in the upper abdomen had disa ppeared. These findings suggest that Ga-67 scintigraphy is useful for diagn osis and observation during treatment of tuberculous peritonitis.