There are very few articles in the literature describing the role of scintigraphy in the differential diagnosis of lymphoma and toxoplasmosis in AIDS patients with multiple ring enhancing brain lesions. Most of the articles are based on differential thallium uptake by these two disease entities. In AIDS patients, symptoms are usually of gradual onset, there is frequently widespread dissemination, and treatment has been generally unsatisfactory. Gallium scan has been the most common scintigraphic study performed in AIDS patients with MAI infection, because usually the sites of infection have increased gallium uptake. Cytomegalovirus Infections CMV is another cause of serious infections in the AIDS population.
Modes of transmission is blood, sexual, or during pregnancy and perinatal.
Palestro CJ et al studied a case of AIDS patient with fever, in whom In-111 labeled leukocyte scan showed pancolitis but gallium scan did not show more than normal excretion of the tracer. Colonic biopsy confirmed the diagnosis of CMV colitis. Scintigraphic studies of the infectious manifestations of AIDS can be a very helpful tool for the clinicians taking care of these patients, since they provide non-invasive, convenient ways at a reasonable cost to diagnose these diseases early in the patient's clinical course, leading to significant decrease in morbidity or early mortality. Gallium scintigraphy has been traditionally the first line of scans used in the evaluation of AIDS patients with fever. However, some authors recommend labeled white blood cells scan as the first line studies for those febrile patients without localizing signs, and use gallium scan for those patients whose symptoms are predominantly pulmonary.