An unusual presentation of scrub typhus with lateral rectus palsy in a child


  • Jeslin Joshy Chiramel Department of Paediatrics, Aster CMI Hospital, Bengaluru, Karnataka, India
  • Parimala V. Thirumalesh Department of Paediatrics, Aster CMI Hospital, Bengaluru, Karnataka, India



Scrub typhus, Orientia tsutsugamushi, Meningitis, Lateral rectus palsy


Scrub typhus, an acute febrile infectious disease prevalent in the “Tsutsugamushi triangle”, is a mite-born rickettsial zoonosis, caused by Orientia tsutsugamushi. Although the clinical presentation is protean, it rarely causes abducens nerve palsy. We report a 13-year-old previously healthy Indian boy who presented with a recent onset right abducens nerve palsy, headache and fever but without the classic dermatological manifestation (“eschar”) of the disease. After exclusion of common infectious and other causes, he was finally diagnosed with scrub typhus associated with an abducens nerve palsy, which responded to doxycycline therapy.


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