Scrub Typhus and Bilateral Lateral Rectus Palsy: An Uncommon Manifestation

Scrub typhus is a zoonotic disease that typically presents as an acute febrile illness. It is caused by the rickettsial organism <i>Orientia tsutsugamushi</i>, which is prevalent in the Asian region. The clinical manifestations of scrub typhus can vary significantly, ranging from mild febrile illness to severe multiorgan dysfunction syndrome. While the clinical presentation can be diverse, abducens nerve palsy is an extremely uncommon complication reported. This report discusses a 14-year-old previously healthy girl, who exhibited sudden onset of bilateral abducens nerve palsy, accompanied by headache and fever, but without the characteristic skin lesion known as "eschar." After ruling out common infectious diseases and other potential causes, she was ultimately diagnosed with scrub typhus complicated by abducens nerve palsy, which showed full recovery with doxycycline treatment.