Abstract
Scrub typhus is an acute febrile rickettsial disease caused by Orientia tsutsugamushi. It infects endothelial cells and causes vasculitis, the predominant clinico-pathological feature of the disease. This results in disseminated inflammatory perivascular lesions leading to damage to the blood vessels affecting multiple end organs. Abducens nerve palsy is a known but extremely rare and reversible complication of scrub typhus. We present a case of scrub typhus with sixth cranial nerve involvement which responded to treatment with doxycycline.
Highlights
Scrub typhus is an acute febrile rickettsial disease caused by gram-negative obligate intracellular parasite “Orientia tsutsugamushi.”
Central nervous system (CNS) involvement in scrub typhus manifests as the presence of meningitis, encephalomyelitis, eighth cranial nerve involvement resulting in deafness and peripheral neuropathy.[2]
This patient was residing in North India, which is known to be endemic for scrub typhus infection
Summary
Scrub typhus is an acute febrile rickettsial disease caused by gram-negative obligate intracellular parasite “Orientia tsutsugamushi.” It proliferates within the endothelial cells of the blood vessels and causes vasculitis, the predominant clinicopathological feature of the disease.[1]. Scrub typhus is an acute febrile rickettsial disease caused by gram-negative obligate intracellular parasite “Orientia tsutsugamushi.”. It proliferates within the endothelial cells of the blood vessels and causes vasculitis, the predominant clinicopathological feature of the disease.[1] Scrub typhus presents with variable clinical manifestations which may range from simple flulike illness to potentially life-threatening multiorgan failure. We present a case of unilateral reversible abducens nerve palsy in a child with scrub typhus which resolved completely following treatment. Fever and vomiting subsided and the child improved symptomatically by third day of admission. Her lateral rectus palsy persisted which resolved when she came for follow up after one week
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