Papilledema: A Rare Presentation of Scrub Typhus

Scrub typhus, an infection caused by Orientia tsutsugamushi, often manifests as an undifferentiated fever that may progress to multisystem involvement in severe cases.Ocular complications are unusual, with papilledema being among the rarest findings.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 IV papilledema, despite a normal neuroimaging study.Cranial nerve examination was nonfocal.Other causes of raised intracranial pressure (ICP) were excluded, implicating scrub typhus as the likely etiology.The patient showed clinical and ophthalmologic improvement with continued doxycycline therapy.This report underscores the value of including scrub typhus in the differential diagnosis when papilledema is observed in patients from endemic zones, emphasizing timely ocular evaluation in those presenting with neurological complaints.