Scrub typhus: A rare cause of encephalitis in pediatric age group

Rickettsial diseases are caused by arthropod-borne obligate intracellular parasites. One such rickettsial infection is scrub typhus, which is an important cause of fever of unknown origin. Spectrum of presentation is variable. There are reports of scrub typhus with CNS complication, like meningoencephalitis, in adolescents and adults from various parts of India but not from Delhi. There are recent case reports of scrub typhus without CNS involvement in adults from Delhi. Its occurrence in the form of hemorrhagic fever with meningoencephalitis is rarer in children and is not so far reported from the state of Delhi. We present a case of a 4-year-old child from Delhi presenting with hepatosplenomegaly, thrombocytopenia, and altered sensorium, whose timely diagnosis and management saved her life, and this brings to our notice the emergence of scrub encephalitis in children.