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Scrub typhus: radiological and clinical findings in abdominopelvic involvement

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Abstract

Purpose

To describe the clinical and radiological findings of abdominopelvic involvement in scrub typhus.

Materials and methods

Abdominopelvic computed tomography (CT) of 78 patients with scrub typhus were evaluated by two readers. The presence of gallbladder wall thickening, arterial inhomogeneous enhancement of the liver, periportal edema, splenic infarction, hepatomegaly, splenomegaly, ascites, pleural effusion, and sites of lymphadenopathy were evaluated. Patients were divided into four clinical subgroups according to laboratory findings. Association between imaging findings and subgroups was analyzed by Chi squared test or Fisher’s exact test.

Results

The most common CT finding was hepatomegaly (74.4%), followed by splenomegaly (66.7%). The majority of patients had at least three areas of abdominopelvic lymphadenopathy (71.8%). Pelvic lymphadenopathy was most commonly seen when eschar was found in the ipsilateral lower extremity (left, n = 5/7; right, n = 8/13). Significant association between hepatic dysfunction and perigastric lymphadenopathy was documented (p = 0.03).

Conclusion

Scrub typhus has a spectrum of variable clinical and radiological findings mimicking those of acute hepatitis. Diffuse abdominopelvic lymphadenopathy involving the retroperitoneum and pelvic area may aid in early diagnosis of scrub typhus. Perigastric lymphadenopathy could be a sign of severe scrub typhus combined with hepatic dysfunction.

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Authors and Affiliations

  1. Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea

    Kun Yung Kim, Ji Soo Song, Eun Hae Park & Gong Yong Jin

  2. Research Institute of Clinical Medicine of Chonbuk National University, Jeonju, Korea

    Ji Soo Song, Eun Hae Park & Gong Yong Jin

  3. Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea

    Ji Soo Song, Eun Hae Park & Gong Yong Jin

Authors
  1. Kun Yung Kim
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  2. Ji Soo Song
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  4. Gong Yong Jin
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Correspondence to Ji Soo Song.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was waived by our institutional review board due to the retrospective nature of the study.

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Kim, K.Y., Song, J.S., Park, E.H. et al. Scrub typhus: radiological and clinical findings in abdominopelvic involvement. Jpn J Radiol 35, 101–108 (2017). https://doi.org/10.1007/s11604-016-0607-6

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  • DOI: https://doi.org/10.1007/s11604-016-0607-6

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