Abstract
A 65-year-old man had classic pyrexia of unknown origin. He was known to have polycystic disease of the liver and kidneys, adenocarcinoma of the lower esophagus, and Dukes A villous adenoma. Ultrasound and CT confirmed polycystic disease but showed no evidence of infection or secondary deposits in these organs. Planar and SPECT Ga-67 citrate scintigraphy showed a donut sign in the liver suggesting infection in a single cyst. Ultrasound showed this area to correspond to one of the large liver cysts. Aspiration of pus confirmed the site of infection with improvement of pyrexia.
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