Scrub typhus also known as ‘Tsutsugamushi disease’ is a mite borne bacterial infection caused by Orientia tsutsugamushi. Usually the symptoms are mild and the clinical course is uneventful. However, some patients may experience severe fatal events involving multi organ system. We report a 23 year old patient, admitted with fever, skin lesion and unconsciousness and was diagnosed to have scrub typhus with multiorgan dysfunction and hypoalbuminemia resulting in fatal outcome. The aim of this case report is to reemphasize that hypoalbuminemia with multi organ dysfunction could lead to fatal outcome in scrub typhus.