A rare etiology behind isolated lateral rectus palsy: Scrub typhus

Scrub typhus (ST), a zoonotic disease, is currently being recognized as a significant contributor to the changing landscape of infectious diseases in India. As one of the important causes of febrile illness, in many parts of the country, general practitioners need to include it as part of the workup for cases of fever of unknown origin. While very amenable to early treatment with a simple regime of doxycycline, delayed diagnosis can result in a spectrum of complications. We report here one such complication of a case of ST manifesting with isolated lateral rectus palsy, which, to the best of our knowledge, has been reported only thrice in the world previously. Family physicians also need to be aware of the availability in India of affordable serological testing for ST that is useful for rapid and inexpensive diagnosis, leading to timely treatment.