Clinical role of interstitial pneumonia in patients with scrub typhus: a possible marker of disease severity.
Interstitial pneumonia (IP) frequently occurs in patients with scrub typhus, but its clinical significance is not well known. This study was designed to evaluate interstitial pneumonia as a marker of severity of the disease for patients with scrub typhus. We investigated clinical parameters representing the severity of the disease, and the chest radiographic findings for 101 patients with scrub typhus. We then compared these clinical factors between patients with and without IP. We also studied the relationship between IP and other chest radiographic findings. The chest radiography showed IP (51.4%), pleural effusion (42.6%), cardiomegaly (14.9%), pulmonary alveolar edema (20.8%), hilar lymphadenopathy (13.8%) and focal atelectasis (11.8%), respectively. The patients with IP (n=52) had higher incidences in episode of hypoxia (p=0.030), hypotension (p=0.024), severe thrombocytopenia (p=0.036) and hypoalbuminemia (p=0.013) than the patients without IP (n=49). The patients with IP also had higher incidences of pleural effusion (p<0.001), focal atelectasis (p=0.019), cardiomegaly (p<0.001), pulmonary alveolar edema (p=0.011) and hilar lymphadenopathy (p<0.001) than the patients without IP. Our data suggest that IP frequently occurs for patients with scrub typhus and its presence is closely associated with the disease severity of scrub typhus.
Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Sun Wha
SW
Song
Ki Tae
KT
Kim
Young Mi
YM
Ku
Seog Hee
SH
Park
Young Soo
YS
Kim
Dong Gun
DG
Lee
Sun Ae
SA
Yoon
Young Ok
YO
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D015994:Incidence; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D012612:Scrub Typhus / Q000150:complications* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012720:Severity of Illness Index