Imaging Quiz: Fever of Undetermined Origin in a Soldier

Carlos E. Jiménez, MD; Inku Hwang, MD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 25 - NO. 6 - JUNE 97

An athletic 26-year-old black male soldier presented with a 5-week history of intermittent fever up to a maximum of 102°F (38.9°C), 10-lb weight loss, and malaise. He denied any localizing signs or symptoms. At the time of admission his medical, surgical, and travel histories were unremarkable; and the physical exam, including his temperature, was within normal limits. His only medication was occasional use of acetaminophen, and his only lab abnormalities were a blood urea nitrogen of 58 mg/dL and serum creatinine of 3.4 mg/dL.

The patient was admitted. Further work-up, including a chest radiograph, renal ultrasonogram, abdominal/pelvic computed tomogram, a test for the human immunodeficiency virus (HIV), and urine and blood cultures, was negative. Following intravenous infusion of 10 mCi of gallium 67 citrate, 72-hour whole-body images were acquired (figure 1).

What is your diagnosis, and what treatment would you recommend?

What is your diagnosis

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