The Utility of Gallium Scan in Patients With Perinephric Abscess and Septic Pulmonary Emboli in the Absence of Right-Sided Infective Endocarditis: A Case Report.

Abstract

A 43-year-old male with newly diagnosed diabetes developed methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia following a foot injury. Despite appropriate antibiotic treatment, the patient's blood cultures remained persistently positive, and imaging revealed septic pulmonary emboli. Both transthoracic and transesophageal echocardiography showed no evidence of right-sided infective endocarditis. A gallium scan, followed by CT and MRI, identified a perinephric abscess as the source of infection. After drainage of the abscess and prolonged antibiotic therapy, the bacteremia was resolved, and pulmonary septic foci were reduced. This case highlights the importance of considering extracardiac sources, such as perinephric abscesses, in cases of persistent bacteremia and septic pulmonary emboli, especially when there is no evidence of endocarditis. And the remarkable utility of gallium scans to detect hidden infections.