Pulmonary Manifestations of Scrub Typhus: Wisdom May Prevail Obstacles

Kashyap, Surender; Solanki, Anjali

doi:10.4172/2161-105x.1000251

Cited by 5 publications

(6 citation statements)

References 24 publications

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“… 36 37 Respiratory complications of scrub typhus can be presented in the form of interstitial pneumonia frequently and the incidence of chest radiographic abnormalities in patients with scrub typhus varies from 59% to 72%. 38 39 Therefore, there is a possibility that the clinicians misdiagnose atypical pathogens including scrub typhus and treat it with ordinary CAP empiric antibiotics which can effect on the clinical outcome of CAP.…”

Section: Discussionmentioning

confidence: 99%

Beta-Lactam Plus Macrolide for Patients Hospitalized With Community-Acquired Pneumonia: Difference Between Autumn and Spring

et al. 2022

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Background The 2017 Korean guideline on community-acquired pneumonia (CAP) recommended beta-lactam plus macrolide combination therapy for patients hospitalized with severe pneumonia, and beta-lactam monotherapy for mild-to-moderate pneumonia. However, antibiotic treatment regimen for mild-to-moderate CAP has never been evaluated for Korean patients. Methods In this retrospective cohort study, study patients were selected from three evaluation periods (October 1 to December 31, 2014; April 1 to June 30, 2016; October 1 to December 31, 2017) of the National Quality Assessment Program for CAP management and the National Health Insurance data on the selected patients was extracted from 1 year before the first patient enrollment and 1 year after the last patient enrollment at each evaluation period for the analysis of risk adjustment and outcomes. The survival rates between beta-lactam plus macrolide (BM) groups and beta-lactam monotherapy (B) were compared using a Kaplan-Meier survival analysis after propensity score matching by age, gender, confusion, urea, respiratory rate, blood pressure at age of 65 years or older (CURB-65), and Charlson comorbidity index for risk adjustment. The differences between autumn and spring season were also evaluated. Results A total of 30,053 patients were enrolled. Mean age and the male-to-female ratio were 64.7 ± 18.4 and 14,197:15,856, respectively. After matching, 2,397 patients in each group were analyzed. The 30-day survival rates did not differ between the BM and B groups (97.3% vs. 96.5%, P = 0.081). In patients with CURB-65 ≥ 2, the 30-day survival rate was higher in the BM than in the B group (93.7% vs. 91.0%, P = 0.044). Among patients with CURB-65 ≥ 2, the 30-day survival rate was higher in the BM than in the B group (93.3% vs. 88.5%, P = 0.009) during autumn season, which was not observed during spring (94.2% vs. 94.1%, P = 0.986). Conclusion Beta-lactam plus macrolide combination therapy shows potential as an empirical therapy for CAP with CURB-65 ≥ 2, especially in autumn.

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Section: Discussionmentioning

confidence: 99%

Beta-Lactam Plus Macrolide for Patients Hospitalized With Community-Acquired Pneumonia: Difference Between Autumn and Spring

et al. 2022

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“…Chest x-ray abnormalities are seen in 59 to 72% of patients. 5 It shows interstitial pneumonia, hilar lymphadenopathy, bilateral diffuse reticulonodular opacities and pleural effusion. More the severity of interstitial pneumonia, more the mortality from scrub typhus.…”

Section: Discussion Discussionmentioning

confidence: 99%

Scrub Typhus Presenting as Lobar Pneumonia: A Case Report on Uncommon Presentation of Scrub Typhus

Srinithi

Ramanathan

Krithika

et al. 2021

GJMS

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Scrub typhus is an acute febrile illness which is noted in children increasingly nowadays but it is often underdiagnosed mostly due to its atypical presentation. In this report, we present a case of 10 years old boy, who was initially diagnosed as lobar pneumonia but later confirmed to be suffering from scrub typhus infection. The child had typical clinical as well as radiological features of community-acquired pneumonia. Further investigations were done due to non-response to initial treatment which led to the diagnosis of scrub typhus infection. Specific treatment with doxycycline showed dramatic response and the child improved clinically. So it is absolutely essential for the treating physician to have high index of suspicion of this re-emerging infectious disease.

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“…Basic pathology is interstitial pneumonia with or without vasculitis [12]. The incidence of chest radiographic abnormalities in patients with scrub typhus varies from 59% to 72% [13]. The most common radiological findings reported in the literature are interstitial pneumonia, bilateral diffuse areas of reticulonodular opacity, hilar adenopathy, pleural effusion, and focal atelectasis.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Clinical Presentation of Scrub Typhus

Sethuraman

Balasubramanian

2019

Cureus

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Scrub typhus is still underdiagnosed despite a resurgence in incidence as the clinical presentation is often atypical leading to low index of suspicion among clinicians. We report a case of a young girl presenting as lobar pneumonia and diagnosed as scrub typhus. Despite such a classical picture of community-acquired pneumonia on clinical presentation and radiological findings the patient was found to have scrub typhus serologically thereby posing a diagnostic dilemma. Upon serological confirmation, doxycycline therapy was initiated followed by a rapid and complete resolution of pneumonia, both clinically and radiographically. This case report highlights the importance of recognizing an uncommon clinical presentation of this common tropical disease and its prompt diagnosis and treatment.

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Pulmonary Manifestations of Scrub Typhus: Wisdom May Prevail Obstacles

Cited by 5 publications

References 24 publications

Beta-Lactam Plus Macrolide for Patients Hospitalized With Community-Acquired Pneumonia: Difference Between Autumn and Spring

Beta-Lactam Plus Macrolide for Patients Hospitalized With Community-Acquired Pneumonia: Difference Between Autumn and Spring

Scrub Typhus Presenting as Lobar Pneumonia: A Case Report on Uncommon Presentation of Scrub Typhus

An Unusual Clinical Presentation of Scrub Typhus

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