Gallium-67 scintigraphy in an AIDS patients presenting tuberculous pericarditis

The case of a 31-year-old HIV-positive male drug addict, with a history of recurrent intermittent fever is presented. Chest x-ray showed right ilar-node enlargement and moderate venous congestion. A 67Ga-citrate scan of the chest was highly suggestive of Mycobacterial infection. Scans showed right supraclavicular, right costophrenic, hilar node, pericardial and low grade pulmonary tracer uptake. Therapy with streptomycin, ethambutol, isoniazid and pyrazinamide was started. After 8 weeks, a chest roentgenogram was normal and 67Ga-citrate scintigraphy showed only right hilar node tracer uptake. Biopsy specimen cultures then confirmed the diagnosis of Mycobacterium tuberculosis infection. This case is interesting because of (1) the uncommon pericardial tracer uptake, and (2) because it confirms the usefulness of 67Ga-citrate scan for the early diagnosis of Mycobacterial infection.