Scrub typhus: radiological and clinical findings

Area of Science:

• Infectious Diseases
• Radiology
• Pulmonology

Background:

• Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi.
• Clinical and radiological manifestations are crucial for early diagnosis.

Purpose of the Study:

• To delineate the radiological and clinical features of scrub typhus.
• To correlate imaging findings with clinical presentation.

Main Methods:

• Retrospective analysis of 75 scrub typhus patients.
• Review of chest radiographs and thin-section CT scans.
• Radiological findings assessed by three independent radiologists.

Main Results:

• Common symptoms: fever (98%), myalgia (81%), headache (80%). Common signs: rash (79%), eschar (75%).
• Radiographic abnormalities in 72% of patients, predominantly parenchymal (71%) with lower lung predilection.
• Frequent findings: bilateral reticulonodular opacities (40%), ground-glass opacity (25%), consolidation (25%), septal lines (36%). Thin-section CT highlighted ground-glass opacity (89%) in lower zones.

Conclusions:

• Scrub typhus typically presents as an acute febrile illness with eschar.
• Pulmonary interstitial disease, often with lower lung predominance, is a key radiographic finding.
• Imaging may reveal pulmonary edema secondary to cardiac dysfunction.