A Clinical Conundrum Solved with Indium-111 White Blood Cell Scanning

Abstract

A 70-year-old man had agnogenic myeloid metaplasia. He had aplastic anemia in the months before admission and was receiving weekly transfusions of packed erythrocytes and platelets. Before admission, he sustained trauma to the left calf that resulted in a large bruise and swelling. During his weekly transfusion, he became febrile and was hospitalized. A source of the fever could not be localized. An ultrasound of his lower extremity revealed a complex subcutaneous fluid collection, but in light of his recent trauma, a resolving hematoma could not be ruled out. An indium-111 white blood cell scan showed fusiform uptake in the soft tissues of the midcalf. The patient underwent incision and drainage of the abscess, his fever abated, and he was discharged from the hospital.