A Ga-67 scan performed because of a suspected intraabdominal infection demonstrated marked pericardial uptake of the isotope instead, and thus provided the first clue to the diagnosis of purulent pericarditis. Susequent studies and surgery revealed an esophagopericardial fistula, gas in the pericardial sac, and purulent pericarditis casued by multiple bacteria. This report presents an unusual cause of pericardil uptake of Ga-67. The use of Ga-67 scanning to diagnose purulent pericarditis in the absence of typical clinical findings is illustrated.
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