Case on encephalopathy

A k/c/co DM, HTN newly diagnosed CLD with hepatic encephalopathy came with c/o altered sensorium for 1 day with no loc,seizure,vomiting,fever,giddiness. O/E pt was tachycardia and spo2 90% at RA. CBC showed macrocytic anemia with neutrophilia . RFT showed raised urea and creatinine. During hosp stay pts sensorium worsened. MRI was taken. Lumbar puncture could not be done due to mass effect. Later pt became positive for scrub typhus . Was later declared ards with septic shock . What could be the cause of this altered sensorium ? can scrub typhus cause encephalopathy?