Scrub typhus with unusual presentation

Scrub typhus is an acute,febrile zoonosis caused by an obligate intracellular bacterium orientia tsutsugamushi. the clinical manifestations of the disease range from subclinical to fatal organ failure. the common symptoms are fever,chills,headache,myalgia,dry cough,lymphadenopathy,and gastrointestinal disturbances. the presentation with complications is usually due to delay in diagnosis and treatment. we report three cases of scrub typhus that presented with features of meningo-encephalitis,which is very unusual,and all patients recovered with empirical doxycycline treatment.