Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Scrub typhus (tsutsugamushi disease)
- Radiologic Findings
- Diffuse interlobular septal and bronchovascular thickening and mild GGOs in both lung.
Bilateral pleural and pericaridal effusion.
- Brief Review
- Acute febrile illness caused by Orientia tsutsugamushi
Focal or disseminated vasculitis and perivasculitis
Multiorgan involvement: lungs, heart, liver, spleen, and CNS
Humans infected by bite of larval-stage chigger or trombiculid mite
Activity in mite-infested habitats (brush and grass), late fall (Oct–Nov)
PE: eschar at wound site, general/regional lymphadenopathy, maculopapular rash, splenomegaly
Autopsy: interstitial pneumonia (almost), myocardial lesions (80%)
Microscopy: blood vessels congested and surrounded by mononuclear cellular infiltration, interlobular septa and alveolar walls show edema and cellular infiltration
Chest x-ray
Bilateral diffuse reticulonodular opacity, hilar lymph node enlargement, septal line
Pleural effusion (common), airspace consolidation (uncommon)
Cardiomegaly (reversible)
Chest CT
Interlobular septal thickening, axial interstitial thickening, GGO, centrilobular nodules
Lower zone predominance
Mediastinal and axillary lymphadenopathy
- References
- RadioGraphics 2007; 27:161–172, Clinical Radiology 2000; 55:140–144, Korean Radiol Soc 1996; 36:987–990
- Keywords
- Scrub Typhus (Tsutsugamushi disease) ,