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