Bilateral adrenocortical uptake of Ga-67 SPECT during septicemia in a heart transplant patient

Gallium-67 scintigraphy is a valuable agent in the management of fever of unknown origin. The use of SPECT increases its sensitivity and may demonstrate unexpected findings. We report on a heart-transplanted 55-year-old man with postsurgical fever of unknown origin. Ga-67 SPECT showed bilateral abnormal adrenal gland uptake that disappeared after intensive antibiotic therapy as assessed by a new Ga-67 scintigraphy obtained 3 months later. Unilateral and bilateral adrenal uptake of gallium has been reported in several clinical settings, ranging from adrenocortical adenomas to malignant disease such as lymphoma or adrenal metastases. Only one similar case, septicemia with transient adrenal uptake of gallium, has been previously reported.