Scrub Typhus Presenting as Unilateral Abducens Nerve Palsy

Area of Science:

• Neurology
• Infectious Diseases
• Ophthalmology

Background:

• Scrub typhus is an acute febrile illness caused by *Orientia tsutsugamushi*, prevalent in the
• Tsutsugamushi Triangle
• and transmitted by mites.
• Abducens nerve palsy is an uncommon neurological complication of scrub typhus.
• Atypical presentations without fever or eschar can delay diagnosis.

Observation:

• A 14-year-old girl presented with acute onset right abducens nerve palsy and headache.
• She lacked fever and the characteristic eschar, common manifestations of scrub typhus.
• Other potential causes were ruled out.

Findings:

• The patient was diagnosed with scrub typhus associated with abducens nerve palsy.
• Treatment with doxycycline led to a positive clinical response.

Implications:

• This case expands the known clinical spectrum of scrub typhus.
• It emphasizes the importance of considering scrub typhus in patients with abducens nerve palsy, even without typical symptoms.
• Early diagnosis and treatment with doxycycline are crucial for favorable outcomes.