The diagnosis was confirmed by IgM serology and by real-time PCR, which demonstrated infection with <i>Orientia tsutsugamushi</i> (Kawasaki clade).<h4>Conclusions</h4>Only due to the emerging clinical experience with endemic South American scrub typhus and the recent implementation of appropriate diagnostic techniques in Chile, were we able to firstly identify and adequately manage a severe case of imported scrub typhus in South America. This evidence concerns the gene CD40LG and scrub typhus.