Challenging neurological presentation: Scrub typhus with meningoencephalitis and multiple cranial nerve involvement

Abstract

A 40‐year‐old male farmer from rural West Bengal, India, presented with fever, headaches, seizure, eschar, and palsy of left cranial nerves VII, VIII, IX, and X as a rare clinical manifestation of scrub typhus. Positive IgM enzyme‐linked immunosorbent assay tests in serum and cerebrospinal fluid confirmed the diagnosis, with brain magnetic resonance imaging showing meningoencephalitis findings. Treatment with steroids and doxycycline led to neurological improvement. This case highlights the need for heightened clinician awareness toward early detection of scrub typhus's atypical presentations to ensure timely and effective treatment.