Choi Y H, Kim S J, Lee J Y, Pai H J, Lee K Y, Lee Y S
Department of Radiology, Dankook University College of Medicine, Korea.
Clin Radiol. 2000 Feb;55(2):140-4. doi: 10.1053/crad.1999.0336.
To describe the radiological and clinical findings of scrub typhus. We retrospectively analysed the radiographic, thin-section CT and clinical features of scrub typhus.
The study included 75 consecutive patients (median age = 47 years, range = 18-81 years) with scrub typhus. Plain chest radiographs were obtained in all 75 patients and 19 underwent thin-section CT within 6 days of initial radiography. The radiographic and thin-section CT findings were retrospectively analysed by three radiologists.
Most common clinical symptoms were fever (73/75, 98%), myalgia (61/75, 81%) and headache (60/75%, 80%). Rash (59/75, 79%) and eschar (56/75, 75%) were the most common signs. Radiography showed abnormalities in 54/75 (72%) patients. The most frequent findings were parenchymal abnormalities (53/75, 71%) with lower lung predilection including bilateral reticulonodular opacities (30/75, 40%), ground-glass opacity (19/75, 25%), consolidation (19/75, 25%), septal lines (27/75, 36%) and hilar lymph node enlargement (19/75, 25%). Thin-section CT (n = 19) showed ground-glass opacity (17/19, 89%) predominantly in the lower zones. Bronchial wall thickening (11/19, 58%), centrilobular nodules (9/19, 47%) and interlobular septal thickening (9/19, 47%) were less frequent findings.
Scrub typhus is an acute febrile illness characterized by eschar, which usually has a limited course without serious complication. Diffuse bilateral reticulonodular opacities with lower lung predominance was the most frequent radiographic finding. Chest radiography and thin-section CT show pulmonary interstitial disease which may have a component of pulmonary oedema secondary to cardiac dysfunction.
描述恙虫病的影像学和临床特征。我们回顾性分析了恙虫病的X线、薄层CT及临床特征。
本研究纳入75例连续的恙虫病患者（中位年龄 = 47岁，范围 = 18 - 81岁）。所有75例患者均行胸部X线平片检查，其中19例在初次X线检查后6天内接受了薄层CT检查。三位放射科医生对X线和薄层CT表现进行回顾性分析。
最常见的临床症状为发热（73/75，98%）、肌痛（61/75，81%）和头痛（60/75，80%）。皮疹（59/75，79%）和焦痂（56/75，75%）是最常见的体征。X线检查显示75例患者中有54例（72%）存在异常。最常见的表现为实质异常（53/75，71%），以下肺为主，包括双侧网状结节状阴影（30/75，40%）、磨玻璃影（19/75，25%）、实变（19/75，25%）、间隔线（27/75，36%）和肺门淋巴结肿大（19/75，25%）。薄层CT（n = 19）显示磨玻璃影（17/19，89%）主要位于肺下区。支气管壁增厚（11/19，58%）、小叶中心结节（9/19，47%）和小叶间隔增厚（9/19，47%）较少见。
恙虫病是一种以焦痂为特征的急性发热性疾病,通常病程有限，无严重并发症。双肺弥漫性网状结节状阴影以下肺为主是最常见的X线表现。胸部X线平片和薄层CT显示肺部间质性疾病，可能有继发于心脏功能障碍的肺水肿成分。
