title: Scrub typhus associated hepatic dysfunction and abdominal CT findings.
abstract: OBJECTIVE
  This retrospective study investigated abnormal hepatic dysfunction and abdominal computed tomography (CT) findings in scrub typhus.
  
  
  METHODS
  Three hundred forty nine adult patients were diagnosed with scrub typhus. Ninety four underwent abdominal CT. The CT images were reviewed by the attending radiologist. Patient data of history, symptoms, signs, and results of laboratory tests were collected from the electronic medical records.
  
  
  RESULTS
  In 349 patients with scrub typhus, elevation of aspartate aminotransferase (78.5%) and alanine aminotransferase (63.0%) were dominant compared to alkaline phosphatase (27.2%) and total bilirubin (16.1%). Abdominal CT findings of 94 patients were, in descending order of frequency, enlarged lymph node (53.2%), inhomogeneous enhancement of liver (47.9%), splenomegaly (46.8%), ascites (28.7%), low attenuation of periportal areas (27.7%), gallbladder wall thickening (17.0%), and splenic infarct (6.4%). Also, the level of aspartate aminotransferase tended to be elevated according to the number of CT findings (P= 0.028).
  
  
  CONCLUSIONS
  We found that abdominal CT manifestations of scrub typhus with elevated aminotransferases were varied and not specific. However, knowledge of these findings may evoke the recognition of scrub typhus by clinicians in endemic areas.
authors.affiliation: Man Je Park, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Gyeongsangnam-do, Korea.
authors.forename: Man Je
authors.initials: MJ
authors.lastname: Park
authors.affiliation: Hyoun Soo Lee, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Gyeongsangnam-do, Korea.
authors.forename: Hyoun Soo
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Sang Goon Shim, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Gyeongsangnam-do, Korea.
authors.forename: Sang Goon
authors.initials: SG
authors.lastname: Shim
authors.affiliation: So Hee Kim, Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Gyeongsangnam-do, Korea.
authors.forename: So Hee
authors.initials: SH
authors.lastname: Kim
keywords: Computed tomography; Hepatitis; Orientia tsutsugamushi; Scrub typhus