Scrub Typhus Presenting as Unilateral Abducens Nerve Palsy

ABSTRACT

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 14-year-old previously healthy Indian girl who presented with a recent onset right abducens nerve palsy and headache, but without fever and without the classic dermatological manifestation (“eschar”) of the disease. After exclusion of common infectious, autoimmune, and neoplastic causes, she was finally diagnosed with scrub typhus associated with an abducens nerve palsy, which responded to doxycycline therapy.

KEYWORDS:

• Abducens nerve palsy
• Orientia tsutsugamushi
• scrub typhus

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/01658107.2021.1909073.

Author contributions

All authors contributed significantly to the creation of this manuscript; each fulfilled criteria as established by the ICMJE.

Declaration of interest statement

The authors declare that they have no conflict of interest.