Gallium-67-citrate Scanning in Tuberculous Peritonitis

A 32-year old black, alcoholic male was noted to have an abnormal Gallium-67-citrate scan during a work-up for persistent fever. Surgical biopsies revealed findings of the dry form of tuberculosis peritonitis. The literature concerning Gallium-67-citrate scanning was reviewed and its usefulness in inflammatory disease states (including two reports of positive scans in tuberculous peritonitis) was demonstrated. In addition, we have considered the possible mechanisms of Gallium-67-citrate uptake by inflammatory cells and its probable relationship to the granulomas associated with tuberculous peritonitis. We conclude that Gallium-67-citrate scanning is an important diagnostic procedure in the evaluation of a fever of unknown origin. Moreover, it may significantly shorten the diagnostic work-up of those cases of tuberculous peritonitis.