Abducens nerve palsy in a patient with scrub typhus: a case report

• Published in: Tropical biomedicine Vol. 30; no. 4; pp. 706 - 709
• Main Authors: Bhardwaj, B, Panda, P, Revannasiddaiah, S, Bhardwaj, H
• Format: Journal Article
• Language: English
• Published: Malaysia 01.12.2013
• Subjects: Abducens Nerve Diseases - diagnosis; Abducens Nerve Diseases - etiology; Abducens Nerve Diseases - pathology; Anti-Bacterial Agents - therapeutic use; Doxycycline - therapeutic use; Female; Humans; Orientia tsutsugamushi - isolation & purification; Scrub Typhus - complications; Scrub Typhus - diagnosis; Scrub Typhus - drug therapy; Scrub Typhus - pathology; Treatment Outcome; Young Adult
• ISSN: 0127-5720

Abducens nerve palsy is a known but rare complication of a few bacterial and viral infections like Mycoplasma pneumonia, cytomegalovirus, Epstein-Barr virus, Hanta virus, herpes zoster, and measles. Abducens nerve palsy due to scrub typhus is extremely rare and so far only one case has been reported in the literature. Scrub typhus is a febrile illness caused by rickettsia, Orientia tsutsugamushi, a gram negative intracellular obligate parasite which is endemic in Asia. This disease can present with wide range of clinical manifestations with involvement of any organ system, alone or in combination. Central nervous system involvement is very common and includes meningism, altered sensorium to focal neurological deficits. We present a rare manifestation of Scrub typhus in the form of sixth cranial nerve involvement which responded to the treatment with doxycycline.