SPECT/CT imaging can provide improved diagnostic information over traditional planar scintigraphy and SPECT, with more precise anatomic localization and observer confidence. We present 2 patients with polycystic liver disease (PCLD), both with constitutional symptoms and bacteremia. In WBC SPECT/CT images revealed increased WBC localization within a single liver cyst in each case, subsequently drained under imaging guidance. Cultures confirmed the presence of infection, allowing for appropriately directed antibiotic therapy and successful treatment outcomes. These cases illustrate the incremental value of In WBC SPECT/CT fusion imaging for the evaluation of bacteremia in complicated patients.