An Uncommon Presentation of Scrub Typhus:  A Case of Sixth Nerve Palsy

Brij Gandhi; Deepti Chaudhary; Rajiv Yadav

Brij Gandhi PG Resident, Department of Medicine, Swami Dayanand Hospital, Delhi, India
Deepti Chaudhary Consultant Physician, Department of Medicine, Swami Dayanand Hospital, Delhi, India
Rajiv Yadav PG Resident, Department of Medicine, Swami Dayanand Hospital, Delhi, India

Keywords: Scrub Typhus, Orientia tsutsugamushi, Abducens Nerve Palsy, Sixth Cranial Nerve Palsy, Diplopia, Neurological Complication, Doxycycline

Abstract

Scrub typhus, caused by Orientia tsutsugamushi, is an acute febrile illness with rare neurological complications, including sixth cranial nerve palsy. A 30-year-old female from an endemic region presented with fever, abdominal pain, vomiting, and diplopia. Examination revealed isolated left-sided abducens nerve palsy without meningeal signs. Laboratory tests showed elevated liver enzymes, mild CSF pleocytosis, and positive scrub typhus IgM. Intravenous doxycycline (100 mg twice daily) led to fever resolution within 48 hours and complete recovery in two weeks. This case highlights scrub typhus as a potential cause of abducens nerve palsy. Early recognition and doxycycline treatment can ensure a favourable outcome.

How to cite this article:
Gandhi B, Chaudhary D, Yadav. An Uncommon
Presentation of Scrub Typhus: A Case of Sixth
Nerve Palsy. J Adv Res Med 2025; 12(1): 17-20.

DOI: https://doi.org/10.24321/2349.7181.202502

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