Detection of an Abdominal Mycotic Aneurysm on Three-Phase Bone Scan A Case Report

Abstract

A 46-year-old male had low back pain, radiating into the legs, of 4 weeks duration. The patient described a single episode of bloody diarrhea 3 weeks previously, and for the past 3 days had complained of a low grade fever. Abdominal ultrasound and colonoscopy results were negative. Vertebral osteomyelitis was suspected and the patient was referred for a bone scan. The dynamic flow study demonstrated a focal area of increased activity on the anterior view just above the aortic bifurcation extending to the left. This activity was less intense on the blood pool images, while delayed images were normal. The scintigraphic findings were consistent with an abdominal aneurysm. Because an infectious process was suspected on the basis of the history, the possibility of a mycotic aneurysm was questioned. A repeat ultrasound, as well as a CT scan were performed. This confirmed the presence of a 4 cm saccular aneurysm arising from the anterior wall of the aorta just above the bifurcation. Salmonella enterititis was cultured from the resected specimen