Hypoactive Delirium: A Rare Manifestation of Scrub Typhus

Scrub typhus continues to pose a significant threat to life, manifesting in a spectrum that ranges from mild, non-specific febrile illness to severe multi-organ dysfunction. Although neuropsychiatric symptoms are rare in cases of scrub typhus, we present a unique case involving a 60-year-old male who initially exhibited fever and headache, subsequently developing neuropsychiatric symptoms on the third day of hospitalization. Following the exclusion of prevalent metabolic, autoimmune, and infectious conditions, he was diagnosed with hypoactive delirium associated with scrub typhus. This case highlights the complex nature of hypoactive delirium, which may manifest with nonspecific symptoms that are frequently overlooked. Consequently, the recognition of delirium can be particularly difficult, potentially resulting in underdiagnosis in clinical settings.