Concurrent Infection with SARS-CoV-2 and <i>Orientia tsutsugamushi</i> during the COVID-19 Pandemic in the Maldives
The COVID-19 pandemic was the worst public-health crisis in recent history. The impact of the pandemic in tropical regions was further complicated by other endemic tropical diseases, which can cause concurrent infections along with COVID-19. Here, we describe the clinical course of a patient with co...
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| Format: | Article |
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MDPI AG
2023-01-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/8/2/82 |
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| author | Rajib Kumar Dey Hisham Ahmed Imad Pyae Linn Aung Mohamed Faisham Muaz Moosa Mariyam Hasna Aminath Afaa Thundon Ngamprasertchai Wasin Matsee Wang Nguitragool Emi E. Nakayama Tatsuo Shioda |
| author_facet | Rajib Kumar Dey Hisham Ahmed Imad Pyae Linn Aung Mohamed Faisham Muaz Moosa Mariyam Hasna Aminath Afaa Thundon Ngamprasertchai Wasin Matsee Wang Nguitragool Emi E. Nakayama Tatsuo Shioda |
| author_sort | Rajib Kumar Dey |
| collection | DOAJ |
| description | The COVID-19 pandemic was the worst public-health crisis in recent history. The impact of the pandemic in tropical regions was further complicated by other endemic tropical diseases, which can cause concurrent infections along with COVID-19. Here, we describe the clinical course of a patient with concurrent COVID-19 and scrub typhus infection. The patient’s de-identified clinical data were retrieved retrospectively. The patient had progressive breathlessness at the time of presentation and was hospitalized for COVID-19. Respiratory examination revealed dyspnea, tachypnea, and coarse crepitations bilaterally over the entire lung field. Oxygenation was impaired, and a PaO<sub>2</sub>/FiO<sub>2</sub> ratio of 229 suggested acute respiratory distress syndrome. Laboratory tests indicated leukocytosis, thrombocytopenia, ferritinemia, hypoalbuminemia, and transaminitis. Upon revaluation for persistent fever, physical examination revealed an eschar in the right antecubital fossa. Serology further confirmed scrub typhus, with IgM and IgG antibody positivity. A remarkable clinical recovery was achieved with doxycycline. The COVID-19 pandemic might have masked endemic tropical diseases. Clinicians working in endemic regions must always consider common tropical diseases that may present as a co-infection, as in our case. Travel and exposure history are critical guides for narrowing down a differential diagnosis. Early diagnosis and treatment can prevent complications. |
| first_indexed | 2024-03-11T08:02:27Z |
| format | Article |
| id | doaj.art-02b7f7861762416c8f6b40311d2da2a5 |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-03-11T08:02:27Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-02b7f7861762416c8f6b40311d2da2a52023-11-16T23:39:40ZengMDPI AGTropical Medicine and Infectious Disease2414-63662023-01-01828210.3390/tropicalmed8020082Concurrent Infection with SARS-CoV-2 and <i>Orientia tsutsugamushi</i> during the COVID-19 Pandemic in the MaldivesRajib Kumar Dey0Hisham Ahmed Imad1Pyae Linn Aung2Mohamed Faisham3Muaz Moosa4Mariyam Hasna5Aminath Afaa6Thundon Ngamprasertchai7Wasin Matsee8Wang Nguitragool9Emi E. Nakayama10Tatsuo Shioda11Department of Medicine, Indira Gandhi Memorial Hospital, Malé 20002, MaldivesMahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandMahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandDepartment of Medicine, Indira Gandhi Memorial Hospital, Malé 20002, MaldivesDepartment of Medicine, Indira Gandhi Memorial Hospital, Malé 20002, MaldivesDepartment of Medicine, Indira Gandhi Memorial Hospital, Malé 20002, MaldivesDepartment of Medicine, Indira Gandhi Memorial Hospital, Malé 20002, MaldivesThai Travel Clinic, Hospital for Tropical Diseases, Bangkok 10400, ThailandThai Travel Clinic, Hospital for Tropical Diseases, Bangkok 10400, ThailandMahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, ThailandCenter for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, JapanCenter for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, JapanThe COVID-19 pandemic was the worst public-health crisis in recent history. The impact of the pandemic in tropical regions was further complicated by other endemic tropical diseases, which can cause concurrent infections along with COVID-19. Here, we describe the clinical course of a patient with concurrent COVID-19 and scrub typhus infection. The patient’s de-identified clinical data were retrieved retrospectively. The patient had progressive breathlessness at the time of presentation and was hospitalized for COVID-19. Respiratory examination revealed dyspnea, tachypnea, and coarse crepitations bilaterally over the entire lung field. Oxygenation was impaired, and a PaO<sub>2</sub>/FiO<sub>2</sub> ratio of 229 suggested acute respiratory distress syndrome. Laboratory tests indicated leukocytosis, thrombocytopenia, ferritinemia, hypoalbuminemia, and transaminitis. Upon revaluation for persistent fever, physical examination revealed an eschar in the right antecubital fossa. Serology further confirmed scrub typhus, with IgM and IgG antibody positivity. A remarkable clinical recovery was achieved with doxycycline. The COVID-19 pandemic might have masked endemic tropical diseases. Clinicians working in endemic regions must always consider common tropical diseases that may present as a co-infection, as in our case. Travel and exposure history are critical guides for narrowing down a differential diagnosis. Early diagnosis and treatment can prevent complications.https://www.mdpi.com/2414-6366/8/2/82scrub typhus<i>Orientia tsutsugamushi</i>COVID-19SARS-CoV-2co-infectionARDS |
| spellingShingle | Rajib Kumar Dey Hisham Ahmed Imad Pyae Linn Aung Mohamed Faisham Muaz Moosa Mariyam Hasna Aminath Afaa Thundon Ngamprasertchai Wasin Matsee Wang Nguitragool Emi E. Nakayama Tatsuo Shioda Concurrent Infection with SARS-CoV-2 and <i>Orientia tsutsugamushi</i> during the COVID-19 Pandemic in the Maldives Tropical Medicine and Infectious Disease scrub typhus <i>Orientia tsutsugamushi</i> COVID-19 SARS-CoV-2 co-infection ARDS |
| title | Concurrent Infection with SARS-CoV-2 and <i>Orientia tsutsugamushi</i> during the COVID-19 Pandemic in the Maldives |
| title_full | Concurrent Infection with SARS-CoV-2 and <i>Orientia tsutsugamushi</i> during the COVID-19 Pandemic in the Maldives |
| title_fullStr | Concurrent Infection with SARS-CoV-2 and <i>Orientia tsutsugamushi</i> during the COVID-19 Pandemic in the Maldives |
| title_full_unstemmed | Concurrent Infection with SARS-CoV-2 and <i>Orientia tsutsugamushi</i> during the COVID-19 Pandemic in the Maldives |
| title_short | Concurrent Infection with SARS-CoV-2 and <i>Orientia tsutsugamushi</i> during the COVID-19 Pandemic in the Maldives |
| title_sort | concurrent infection with sars cov 2 and i orientia tsutsugamushi i during the covid 19 pandemic in the maldives |
| topic | scrub typhus <i>Orientia tsutsugamushi</i> COVID-19 SARS-CoV-2 co-infection ARDS |
| url | https://www.mdpi.com/2414-6366/8/2/82 |
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