Scrub typhus is an acute, febrile disease of humans that is caused by Orentia Tsutsugamushi. It is transmitted through the bite of chiggers. The spectrum of the clinical severity for scrub typhus ranges from mild to sever e with fatal complication such as meningoencephalitis, pneumonitis, myocarditis. Severe pulmonary involvement e.g. acute respiratory distress syndrome(ARDS) and meningoencephalitis have rarely been obseved since the introduction of specific antibiotic therapy. We experienced a case of scrub typhus manifested with ARDS and meningoencephalitis. The patient was treated with doxycycline, anticonvulsant and mechanical ventilator thrapy.