Kun Yung Kim1, Ji Soo Song2,3,4, Eun Hae Park1,5,6, Gong Yong Jin1,5,6. 1. Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea. 2. Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Korea. pichgo@gmail.com. 3. Research Institute of Clinical Medicine of Chonbuk National University, Jeonju, Korea. pichgo@gmail.com. 4. Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea. pichgo@gmail.com. 5. Research Institute of Clinical Medicine of Chonbuk National University, Jeonju, Korea. 6. Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
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.
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.
Authors: A Charoensak; O Chawalparit; C Suttinont; K Niwattayakul; K Losuwanaluk; S Silpasakorn; Y Suputtamongkol Journal: J Med Assoc Thai Date: 2006-05
Authors: T Gabata; M Kadoya; O Matsui; T Kobayashi; Y Kawamori; J Sanada; N Terayama; S Kobayashi Journal: AJR Am J Roentgenol Date: 2001-03 Impact factor: 3.959
Authors: Sang Jung Park; Jin Dong Kim; Yeon Seok Seo; Beom Jin Park; Min Ju Kim; Soon Ho Um; Chang Ha Kim; Hyung Joon Yim; Soon Koo Baik; Jin Yong Jung; Bora Keum; Yoon Tae Jeen; Hong Sik Lee; Hoon Jai Chun; Chang Duck Kim; Ho Sang Ryu Journal: World J Gastroenterol Date: 2013-04-28 Impact factor: 5.742