title: The Correlation of Endoscopic Findings and Clinical Features in Korean Patients with Scrub Typhus: A Cohort Study.
abstract: Scrub typhus is an infectious disease caused by Orientia tsutsugamushi-induced systemic vasculitis, but the involvement of the gastrointestinal tract and the endoscopic findings associated with scrub typhus are not well understood. We performed a prospective study and recommend performing esophagogastroduodenoscopy (EGD) for all possible scrub typhus patients, regardless of gastrointestinal symptoms. Gastrointestinal symptoms, endoscopic findings and clinical severity based on organ involvement and ICU admission were analyzed. Gastrointestinal symptoms occurred in up to 76.4% of scrub typhus patients. The major endoscopic findings were ulcers (43/127, 33.9%). Interestingly, 7.1% (9/127) of the patients presented with esophageal candidiasis. There was no correlation between the presence or absence of gastrointestinal symptoms and the endoscopic grade (P = 0.995). However, there was a positive correlation between the clinical severity and the endoscopic findings (P = 0.001). Sixty-three percent of the patients presented with erosion or ulcers on prospectively performed endoscopic evaluations, irrespective of gastrointestinal symptoms. Gastrointestinal symptoms did not reflect the need for endoscopy. Scrub typhus patients could have significant endoscopic abnormalities even in the absence of gastrointestinal symptoms.
authors.affiliation: Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea.
authors.forename: Jun
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea.
authors.forename: Dong-Min
authors.initials: DM
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea.
authors.forename: Na Ra
authors.initials: NR
authors.lastname: Yun
authors.affiliation: Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea.
authors.forename: Chan Guk
authors.initials: CG
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea.
authors.forename: Man Woo
authors.initials: MW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002177:Candidiasis / Q000175:diagnosis; D015331:Cohort Studies; D003422:Critical Care; D004724:Endoscopy; D004947:Esophagus / Q000382:microbiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000382:microbiology; D041981:Gastrointestinal Tract / Q000382:microbiology* / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D007723:Korea; D008297:Male; D008875:Middle Aged; D012285:Orientia tsutsugamushi; D011446:Prospective Studies; D056910:Republic of Korea; D012612:Scrub Typhus / Q000175:diagnosis / Q000473:pathology*; D014657:Vasculitis / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology*