Key Clinical Message
Glucose 6 phosphate dehydrogenase (G6PD) deficiency is a well-known red blood cell enzymopathy and a cause of intravascular hemolysis. The patient may present with a chronic or acute episode of hemolysis. This case report presents a child with underlying G6PD deficiency who presented with an episode of extensive intravascular hemolysis, induced by a scrub typhus infection. The essence of this report is a scrub typhus infection without a typical eschar and a covert G6PD enzyme activity found normal during the acute phase of hemolysis, later found to be mild enzyme deficient. Later in the report is how, after systematically ruling out other potential causes, the diagnosis of scrub typhus was eventually confirmed using a reliable serology kit and a false negative covert G6PD enzyme deficiency got uncovered in follow-up reports.