Takizawa Hidenori, Yamaguchi Bunpei, Hase Isano, Tasaka Toshihiro, Ishii Yoshiki
Department of Respiratory Medicine, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital.
Nihon Kokyuki Gakkai Zasshi. 2010 Sep;48(9):706-10.
A 65-year-old-woman complained of lumbago from the end of March 2008. Three weeks later, she visited a local clinic because of high fever, and she was given a diagnosis of urinary tract infection. Although levofloxacin was given, her condition did not improve and she was referred to the urology department of our hospital. Two days after hospitalization, she rapidly developed respiratory failure. Chest CT revealed bilateral pleural effusion, interlobular septal thickening, diffuse ground-glass opacities and mediastinal lymphadenopathy. We suspected scrub typhus because we noticed a localized necrotic skin lesion on her left lower leg. When minocycline was administered, both her clinical condition and radiographic imaging promptly improved. Because lung involvement with scrub typhus is very rare in Japan, we report this case of scrub typhus with various lung findings.
一名65岁女性自2008年3月底起诉说腰痛。三周后，她因高热前往当地诊所就诊，被诊断为尿路感染。尽管使用了左氧氟沙星，但她的病情并未改善，随后被转诊至我院泌尿外科。住院两天后，她迅速出现呼吸衰竭。胸部CT显示双侧胸腔积液、小叶间隔增厚、弥漫性磨玻璃影及纵隔淋巴结肿大。由于我们注意到她左小腿有一处局限性坏死性皮肤病变，故怀疑为恙虫病。给予米诺环素治疗后，她的临床症状和影像学表现均迅速改善。因为恙虫病累及肺部在日本非常罕见，所以我们报告了这例具有多种肺部表现的恙虫病病例。
