Imaging in scrub typhus - a pictorial review

Area of Science:

• Infectious Diseases
• Radiology
• Tropical Medicine

Background:

• Scrub typhus (STy) is a significant rickettsial zoonosis in the Asia-Pacific, transmitted by infected chigger mites.
• It presents as an acute febrile illness with non-specific symptoms, often challenging early diagnosis.
• While eschar and serology confirm diagnosis, they may be absent or negative in early or atypical cases.

Purpose of the Study:

• To highlight the importance of specific radiological features in diagnosing scrub typhus.
• To emphasize the role of imaging in identifying early disease and cases lacking classic signs.
• To underscore how imaging aids in prognostication and complication detection.

Main Methods:

• Review of common radiological findings in scrub typhus patients.
• Correlation of imaging features with clinical presentation and diagnostic markers.
• Analysis of imaging utility in early disease, seronegative cases, and those without eschar.

Main Results:

• Common imaging findings include gallbladder wall edema, hepatosplenomegaly, and reticulonodular lung opacities.
• These nonspecific findings, when present together in at-risk individuals, raise suspicion for STy.
• Imaging is valuable for diagnosing STy when eschar is absent or serology is negative.

Conclusions:

• Awareness of specific imaging patterns is crucial for suspecting scrub typhus.
• Radiological findings can facilitate early diagnosis, especially in challenging cases.
• Prompt diagnosis and treatment with antibiotics are vital for a favorable prognosis in STy.