Severe scrub typhus confirmed early via immunohistochemical staining.
We describe a case of interstitial pneumonia that was confirmed as scrub typhus by immunohistochemical (IHC) staining of an eschar. When a patient presents with interstitial pneumonia accompanied by generalized lymphadenopathy on the thoracic CT scan, clinicians should suspect scrub typhus, especially when the patient has a history of travel to a scrub typhus-endemic area. IHC staining on an eschar revealed invasion by Orientia tsutsugamushi coccobacilli of the patient's sweat ducts and glands as well as vascular endothelium. IHC staining of an eschar could be used as an early-confirmation diagnostic method to establish scrub typhus.
Kim
Dong-Min
DM
Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea. drongkim@chosun.ac.kr
Lim
Sung-Chul
SC
Won
Kyung Jun
KJ
Choi
Yeon-Joo
YJ
Park
Kyung-Hee
KH
Jang
Won-Jong
WJ
D000368:Aged; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017563:Lung Diseases, Interstitial / Q000188:drug therapy / Q000382:microbiology; D012612:Scrub Typhus / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D012680:Sensitivity and Specificity