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Scrub typhus and lateral rectus palsy: an uncommon presentation of a common illness
  1. Ajay Chauhan1,
  2. Aditya Jandial2,
  3. Kundan Mishra3 and
  4. Rajeev Sandal4
  1. 1Internal Medicine, Civil Hospital, Baddi, Distt Solan, Distt Bilaspur, India
  2. 2Department of Internal Medicine, PGIMER, Chandigarh, India
  3. 3Internal Medicine, Army Hospital Research and Referral, New Delhi, India
  4. 4Radiotherapy and Oncology, Indira Gandhi Medical College Cancer Hospital, Shimla, India
  1. Correspondence to Dr Kundan Mishra; mishrak20{at}


Scrub typhus is a zoonosis, which usually manifests as an acute febrile illness. It is caused by a rickettsia, Orientia tsutsugamushi, which is endemic in the Asian region. It can present with varied clinical manifestations, ranging from acute febrile illness to life-threatening multiorgan dysfunction syndrome. Central nervous system involvement in the form of altered sensorium and/or meningitis is frequently observed in scrub typhus. However, isolated cranial nerve involvement is uncommon and so far only a few such cases have been reported in the literature. We present a rare case of scrub typhus with fever and diplopia at presentation, which completely improved with doxycycline-based treatment.

  • infections
  • tropical medicine (infectious disease)
  • infection (neurology)

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  • Twitter @Aditya_PGI, @rajeev_sandal

  • Contributors AC wrote the manuscript and patient management. KM edited manuscript. AJ supervision and pateint management. RS wrote the manuscript and patient management.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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