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

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