title: Scrub typhus: clinical, pathologic, and imaging findings.
abstract: Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. The main pathologic change is focal or disseminated vasculitis caused by the destruction of endothelial cells and the perivascular infiltration of leukocytes. The diagnosis of scrub typhus is based on the patient's history of exposure, clinical features, and results of serologic testing. Regional and generalized lymphadenopathy is common. The pulmonary manifestations of scrub typhus include interstitial pneumonia, interstitial edema, and hemorrhage caused by vasculitis. Abdominal manifestations include splenomegaly, periportal edema, gallbladder wall thickening, and lymphadenopathy. Although the severity of scrub typhus varies considerably, involvement of the central nervous system is seen in almost all patients and can result in meningoencephalitis. A high degree of clinical suspicion and familiarity with the various radiologic manifestations of scrub typhus allow early diagnosis and timely initiation of appropriate therapy, and thereby may help reduce patient morbidity.
authors.affiliation: Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, 1-10 Ami-Dong, Seo-gu, Pusan 602-739, Republic of Korea.
authors.forename: Yeon Joo
authors.initials: YJ
authors.lastname: Jeong
authors.forename: Suk
authors.initials: S
authors.lastname: Kim
authors.forename: Yeh Dae
authors.initials: YD
authors.lastname: Wook
authors.forename: Jun Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Kun-Il
authors.initials: KI
authors.lastname: Kim
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Lee
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000209:etiology*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011859:Radiography; D012612:Scrub Typhus / Q000150:complications* / Q000000981:diagnostic imaging*; D014657:Vasculitis / Q000000981:diagnostic imaging* / Q000209:etiology*