Scrub Typhus Presenting with Bilateral Lateral Rectus Palsy in A Female

Area of Science:

• Infectious Diseases
• Neurology
• Rickettsial Infections

Background:

• Scrub typhus is a significant rickettsial disease endemic in India, often presenting acutely.
• Diagnosis typically relies on symptoms like fever, rash, eschar, and tick exposure, supported by diagnostic tests.

Observation:

• A case of scrub typhus presented with fever, altered sensorium, eschar, and bilateral lateral rectus palsy.
• This highlights the potential for scrub typhus to manifest with isolated neurological deficits, specifically cranial nerve involvement.

Findings:

• The patient presented with classic signs of scrub typhus, including an eschar and fever, complicated by bilateral lateral rectus palsy.
• Treatment with doxycycline resulted in a complete reversal of the neurological deficits observed.

Implications:

• Scrub typhus should be considered in the differential diagnosis for patients presenting with fever, eschar, and cranial nerve palsy.
• Prompt diagnosis and treatment with doxycycline are crucial for managing neuro-scrub typhus and achieving favorable outcomes.