68 Ga-FAPI PET/CT in Disseminated Actinomycosis With Cardiac Infiltration

Actinomycosis is a rare gram-positive bacterial infection, and disseminated actinomycosis (DA) is even more rare in the modern antibiotic era. Histopathologic and microbiological confirmation are the gold standard, and often organisms are difficult to isolate from the culture specimen. We present a 42-year-old immunocompetent patient with DA, who presented initially with right foot swelling and sinus tract with discharge and subsequently went on to present with multifocal involvement, particularly cardiac involvement, which was unresponsive to penicillin, on 68 Ga-FAPI-46 PET/CT.