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The Journal of Nuclear Medicine Vol. 35 No. 6 1038-1040
© 1994 by Society of Nuclear Medicine
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Pneumocystis Carinii Pneumonia Presenting as Focal Bibasilar Uptake on Gallium Scan During Aerosolized Pentamidine Prophylaxis

Rohit Katial, Wayne Honeycutt and Stephen G. Oswald

Department of Medicine
Nuclear Medicine Service, Department of Radiology, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia

Correspondence: For correspondence or reprints contact: Stephen G. Oswald, 4140 Knollcrest Circle N., Martinez, GA 30907.

ABSTRACT

Radionuclide imaging with gallium is commonly performed in the evaluation of patients with suspected Pneumocystis carinii pneumonia (PCP) and is known to be highly sensitive for detection of PCP. We present a patient with acquired immunodeficiency who developed PCP in the bases of both lungs while on aerosolized pentamidine prophylaxis. A gallium scan demonstrated focal uptake in the lung bases, a pattern generally not associated with PCP, and was extremely useful in guiding bronchoscopy. An aerosol ventilation scan performed after complete resolution of the clinical illness demonstrated prominent ventilatory defects in the lung bases corresponding to the regions of previous gallium uptake. We speculate that the underlying ventilatory abnormality may have contributed to poor drug delivery to the lung bases. Pneumocystis carinii pneumonia must be considered with any focal area of gallium accumulation in patients receiving aerosolized pentamidine.

Key Words: Pneumocystis carinii pneumonia • gallium scan • aerosolized pentamidine






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Copyright © 1994 by the Society of Nuclear Medicine.