Papilledema: A Rare Presentation of Scrub Typhus

Dr HEMANT MAHUR; Dr ARPIT AGARWAL; Dr DHEERAJ MITTAL; Dr RAJESH MEENA; Dr NEHA JAIN

doi:10.59793/9s0mht87

Papilledema: A Rare Presentation of Scrub Typhus

Authors

Dr HEMANT MAHUR Senior Professor
Dr ARPIT AGARWAL Junior Resident
Dr DHEERAJ MITTAL Assistant Professor Dept. of Medicine, RNT Medical College, Udaipur, Rajasthan, India
Dr RAJESH MEENA Assistant Professor Dept. of Medicine, RNT Medical College, Udaipur, Rajasthan, India
Dr NEHA JAIN Junior Resident

DOI:

https://doi.org/10.59793/9s0mht87

Keywords:

Scrub typhus,, papilledema,, doxycycline,, ocular manifestations,, neuroinfection

Abstract

Scrub typhus caused by Orientia tsutsugamushi, typically presents with nonspecific febrile illness but can lead to severe
systemic complications. Ocular manifestations are uncommon, and papilledema is a particularly rare finding. We report the
case of a 29-year-old female who presented with fever, headache, and altered sensorium, later diagnosed as scrub typhus
based on positive serology. During treatment with intravenous doxycycline, she developed horizontal diplopia, and fundus
examination revealed grade 4 papilledema, despite a normal neuroimaging study. Cranial nerve examination was nonfocal.
Other causes of raised intracranial pressure were excluded, implicating scrub typhus as the likely etiology. The patient
showed clinical and ophthalmologic improvement with continued doxycycline therapy. This case highlights the importance
of considering scrub typhus in the differential diagnosis of papilledema in endemic areas and underscores the need for early
fundoscopic evaluation in patients with neurological symptoms.

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Published

2025-12-12

Issue

Vol. 36 No. 6 (2025)

Section

Case Report

License

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