Scrub Typhus Presenting as Unilateral Abducens Nerve Palsy: A Case Report

Area of Science:

• Neurology
• Infectious Diseases
• Ophthalmology

Background:

• Abducens nerve palsies are infrequently linked to infectious etiologies.
• Scrub typhus, caused by Orientia tsutsugamushi, is a zoonotic illness prevalent in specific regions.
• Orientia tsutsugamushi can affect the central nervous system, leading to neurological complications.

Observation:

• A previously healthy 23-year-old female presented with fever, abdominal pain, vomiting, and a characteristic eschar.
• Clinical presentation suggested an infectious cause, with neurological symptoms including unilateral abducens nerve palsy.
• Differential diagnoses were excluded, and scrub typhus was confirmed via positive IgM serology.

Findings:

• The patient was diagnosed with scrub typhus-associated unilateral abducens nerve palsy.
• The condition showed a positive response to doxycycline treatment.
• The case highlights a rare neurological manifestation of scrub typhus.

Implications:

• This case underscores the importance of considering scrub typhus in patients with neurological deficits, particularly in endemic areas.
• Accurate serological interpretation is vital for timely diagnosis and appropriate management.
• Prompt treatment with doxycycline can effectively resolve abducens nerve palsy associated with scrub typhus.