Abstract
Scrub typhus is a rickettsial disease caused by O.tsutsugamushi which is maintained by trans-ovarian transmission in trobiculid mite¹. It causes a disseminated vasculitic and perivascular inflammatory lesions resulting in significant vascular leakage and end organ injury.The presentation can vary from self limiting illness to deadly systemic complications like ARDS, pneumonitis, myocarditis,AKI, Hepatic Dysfuntion and neurological manifestations².The classical clinical presentation includes an eschar,maculopapular rash and regional lymphadenopathy which are very rare. Incubation period is 6-21 days. It is important to differentiate it from other tropical fevers. We are reporting a case of scrub typhus from Vellore district of Tamilnadu with multi organ dysfunction in form of ARDS, Myocarditis,hepatic dysfunction and neurological manifestations and finally recovered after prolonged ventilator support.