Manifestation of acute peritonitis and pneumonedema in scrub typhus without eschar: A case report

Figure 1 Computed tomography images. A: Plain computed tomography (CT) scan of the upper abdomen on the first day of hospitalization revealed inflammatory exudation of the peritoneum, with multiple small lymph nodes in the posterior peritoneum; B: Enhanced CT on the second day of hospitalization revealed an enlarged appendix (approximately 9 mm in diameter); C: Enhanced CT on the second day of hospitalization revealed inflammatory exudation of the peritoneum, with multiple small lymph nodes in the posterior peritoneum; D: Plain CT scan on the first day of hospitalization revealed no abnormalities in either lung; E: Enhanced CT on the second day of hospitalization revealed pleural effusion and pulmonary edema in both lungs; F: Plain CT scan on the fourth day of hospitalization revealed expanded lung consolidation range and increased pleural effusion.

Figure 2 Endoscopy on the second day of hospitalization revealed edema of the gastric mucosa but no gastric or duodenal ulcers or perforations. A: Duodenal bulb; B: Gastric antrum; C: Gastric corpus.

Figure 3 Histopathology of the appendix revealed neutrophil and plasma cell infiltration in the blood vessel wall and around the blood vessel. A: × 100; B: × 200; C: × 400.