An unusual case of intraabdominal nocardia abscess detected by Tc-99m HMPAO-labeled WBC study

Images of a 37-year-old woman with Crohn's disease and recent onset of left lower quadrant pain are presented. Physical and radiologic findings were inconclusive. A Tc-99m-HMPAO-WBC study was ordered and found helpful in differentiating active Crohn's disease of the bowel from a localized abscess. Surgical drainage revealed a well-encapsulated Nocardia abscess consistent with the WBC scan findings. The location of this type of infection is unusual for a patient with Crohn's disease not on immunosuppressive drugs.