{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:27:43Z","timestamp":1786728463839,"version":"build-2736575974"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016]]},"abstract":"\n Background and Rationale:<\/jats:title>\n Respiratory system involvement in scrub typhus is seen in 20\u201372% of patients. In endemic areas, good understanding and familiarity with the various radiologic findings of scrub typhus are essential in identifying pulmonary complications.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n Patients admitted to a tertiary care center with scrub typhus between October 2012 and September 2013 and had a chest X ray done were included in the analysis. Details and radiographic findings were noted and factors associated with abnormal X-rays were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The study cohort contained 398 patients. Common presenting complaints included fever (100%), generalized myalgia (83%), headache (65%), dyspnea (54%), cough (24.3%), and altered sensorium (14%). Almost half of the patients (49.4%) had normal chest radiographs. Common radiological pulmonary abnormalities included pleural effusion (14.6%), acute respiratory distress syndrome (14%), airspace opacity (10.5%), reticulonodular opacities (10.3%), peribronchial thickening (5.8%), and pulmonary edema (2%). Cardiomegaly was noted in 3.5% of patients. Breathlessness, presence of an eschar, platelet counts of <20,000 cells\/cumm, and total serum bilirubin >2 mg\/dL had the highest odds of having an abnormal chest radiograph. Patients with an abnormal chest X-ray had a higher requirement of noninvasive ventilation (odds ratio [OR]: 13.98; 95% confidence interval CI: 5.89\u201333.16), invasive ventilation (OR: 18.07; 95% CI: 6.42\u201350.88), inotropes (OR: 8.76; 95% CI: 4.35\u201317.62), higher involvement of other organ systems, longer duration of hospital stay (3.18 \u00b1 3 vs. 7.27 \u00b1 5.58 days;\n P<\/jats:italic>\n < 0.001), and higher mortality (OR: 4.63; 95% CI: 1.54\u201313.85).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Almost half of the patients with scrub typhus have abnormal chest radiographs. Chest radiography should be included as part of basic evaluation at presentation in patients with scrub typhus, especially in those with breathlessness, eschar, jaundice, and severe thrombocytopenia.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/0022-3859.184662","type":"journal-article","created":{"date-parts":[[2016,6,24]],"date-time":"2016-06-24T02:11:15Z","timestamp":1466734275000},"page":"235-238","source":"Crossref","is-referenced-by-count":13,"title":["Chest radiographic manifestations of scrub typhus"],"prefix":"10.4103","volume":"62","author":[{"given":"KPP","family":"Abhilash","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PR","family":"Mannam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Rajendran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RA","family":"John","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Ramasami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-5-20240205","first-page":"794","article-title":"Scrub typhus in the Western Pacific region","volume":"26","author":"Silpapojakul","year":"1997","journal-title":"Ann Acad Med 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(Tsutsugamushi Disease) and other rickettsial diseases","volume":"21","author":"Allen","year":"1945","journal-title":"Am J Pathol"},{"key":"R6-5-20240205","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1053\/crad.1999.0336","article-title":"Scrub typhus: Radiological and clinical findings","volume":"55","author":"Choi","year":"2000","journal-title":"Clin Radiol"},{"key":"R7-5-20240205","first-page":"600","article-title":"Scrub typhus: Chest radiographic and clinical findings in 130 Thai patients","volume":"89","author":"Charoensak","year":"2006","journal-title":"J Med Assoc Thai"},{"key":"R8-5-20240205","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/1471-2334-10-108","article-title":"Clinical and laboratory findings associated with severe scrub typhus","volume":"10","author":"Kim","year":"2010","journal-title":"BMC Infect Dis"},{"key":"R9-5-20240205","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.ijid.2014.02.009","article-title":"Clinical profile and improving mortality trend of scrub typhus in South India","volume":"23","author":"Varghese","year":"2014","journal-title":"Int J Infect Dis"},{"key":"R10-5-20240205","first-page":"24","article-title":"Outbreak of scrub typhus in Pondicherry","volume":"58","author":"Vivekanandan","year":"2010","journal-title":"J Assoc Physicians India"},{"key":"R11-5-20240205","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.3201\/eid1210.051697","article-title":"Scrub typhus in Himalayas","volume":"12","author":"Mahajan","year":"2006","journal-title":"Emerg Infect Dis"},{"key":"R12-5-20240205","doi-asserted-by":"crossref","first-page":"177","DOI":"10.4103\/0022-3859.118033","article-title":"Eschar in scrub typhus: A valuable clue to the diagnosis","volume":"59","author":"Kundavaram","year":"2013","journal-title":"J Postgrad Med"},{"key":"R13-5-20240205","doi-asserted-by":"crossref","first-page":"750","DOI":"10.3348\/jkrs.1988.24.5.750","article-title":"Pulmonary manifestations of tsutsugamushi disease","volume":"24","author":"Im","year":"1988","journal-title":"J Korean Radiol Soc"},{"key":"R14-5-20240205","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1093\/qjmed\/95.2.126","article-title":"Acute respiratory distress syndrome in scrub typhus","volume":"95","author":"Tsay","year":"2002","journal-title":"QJM"},{"key":"R15-5-20240205","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S1873-9598(10)70005-3","article-title":"Radiologic pulmonary findings, clinical manifestations and serious complications in scrub typhus: Experiences from a teaching hospital in Eastern Taiwan","volume":"3","author":"Wu","year":"2009","journal-title":"Int J Gerontol"},{"key":"R16-5-20240205","doi-asserted-by":"crossref","first-page":"205","DOI":"10.3348\/jkrs.1993.29.2.205","article-title":"Chest radiographic findings of scrub typhus: An analysis of 160 cases occurred in Ulsan area","volume":"29","author":"Kim","year":"1993","journal-title":"J Korean Radiol 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