Clinical role of interstitial pneumonia in patients with scrub typhus: a possible marker of disease severity

J Korean Med Sci. 2004 Oct;19(5):668-73. doi: 10.3346/jkms.2004.19.5.668.

Abstract

Interstitial pneumonia (IP) frequently occurs in patients with scrub typhus, but its clinical significance is not well known. This study was designed to evaluate interstitial pneumonia as a marker of severity of the disease for patients with scrub typhus. We investigated clinical parameters representing the severity of the disease, and the chest radiographic findings for 101 patients with scrub typhus. We then compared these clinical factors between patients with and without IP. We also studied the relationship between IP and other chest radiographic findings. The chest radiography showed IP (51.4%), pleural effusion (42.6%), cardiomegaly (14.9%), pulmonary alveolar edema (20.8%), hilar lymphadenopathy (13.8%) and focal atelectasis (11.8%), respectively. The patients with IP (n=52) had higher incidences in episode of hypoxia (p=0.030), hypotension (p=0.024), severe thrombocytopenia (p=0.036) and hypoalbuminemia (p=0.013) than the patients without IP (n=49). The patients with IP also had higher incidences of pleural effusion (p<0.001), focal atelectasis (p=0.019), cardiomegaly (p<0.001), pulmonary alveolar edema (p=0.011) and hilar lymphadenopathy (p<0.001) than the patients without IP. Our data suggest that IP frequently occurs for patients with scrub typhus and its presence is closely associated with the disease severity of scrub typhus.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorescent Antibody Technique, Indirect
  • Humans
  • Incidence
  • Lung / diagnostic imaging
  • Lung / microbiology
  • Lung Diseases, Interstitial / diagnostic imaging*
  • Lung Diseases, Interstitial / epidemiology
  • Lung Diseases, Interstitial / microbiology*
  • Male
  • Middle Aged
  • Pleural Effusion / diagnostic imaging
  • Pleural Effusion / epidemiology
  • Pleural Effusion / microbiology
  • Predictive Value of Tests
  • Prognosis
  • Radiography
  • Scrub Typhus / complications*
  • Scrub Typhus / diagnostic imaging*
  • Scrub Typhus / epidemiology
  • Severity of Illness Index*