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Trop Biomed. 2013 Dec;30(4):706-9.

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

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  • 1Indira Gandhi Medical College, Department of Pulmonary Medicine and Tuberculosis Shimla, Himachal Pradesh, India: 171001.
  • 2Department of Cardiology, Indira Gandhi Medical College Shimla, India.
  • 3Department of Radiation Oncology, Health Care Global-Bangalore Institute of Oncology, Bengaluru, Karnataka, India.
  • 4Pulmonary Medicine & Critical Care, Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA.


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.

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