Identifying a source of fever is often difficult, particularly for hospitalized patients with multiple underlying illnesses. Radionuclide scans (gallium67 or indium111) have been proposed as diagnostic tools for localizing a fever source. We sought to determine the usefulness of these scans in a group of febrile patients seen at a university medical center. We retrospectively reviewed the records of all inpatients and outpatients at our institution who underwent either gallium67 or indium111 scanning between 1990 and 1995. Records were reviewed for patient demographics, scan indication, prior workup (imaging studies of both chest and abdomen), source of fever (as determined by the treating MD), and fever duration. A scan was determined to have localized the fever source if the result coincided with the proven or likely source of fever. Patient records for 290 scans were reviewed. One hundred fifteen of the 290 (39.6%) scans were performed on 108 patients for the evaluation of fever. Of this group 50% were male; mean age was 31.9; 94.7% were inpatients; 43% used gallium67, 57% used indium111. Upon completion of all diagnostic studies, a proven or likely source of fever was determined in 53 cases (46%). Radionuclide scans localized or confirmed the source of fever in 16.5% of cases (19/115). There was no difference whether gallium67 or indium111 was utilized. Efficacy was similar for patients irrespective of prior workup. For the subgroup of patients with a fever duration >21 days, scans localized the fever source in 9.6% of cases while for patients with a fever duration of <7 days, the figure was 19.2%. For children less than 6 years old scans localized the fever source in 21% of cases. We conclude that radionuclide scanning as a means of localizing a source of fever is useful in a minority of cases and that the usefulness decreases as fever duration increases. A careful prospective trial is necessary to determine which subgroups of febrile patients might benefit most from these scans.
|Original language||English (US)|
|Number of pages||1|
|Journal||Clinical Infectious Diseases|
|State||Published - Dec 1 1997|
All Science Journal Classification (ASJC) codes
- Microbiology (medical)
- Infectious Diseases