Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas
The febrile patient from tropical areas, in which emerging arboviruses are endemic, represents a diagnostic challenge, and potential co-infections with other pathogens (i.e., bacteria or parasites) are usually overlooked. We present a case of an elderly woman diagnosed with dengue, chikungunya and &...
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| Format: | Article |
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MDPI AG
2018-11-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/3/4/123 |
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| author | Jaime A. Cardona-Ospina Carlos E. Jiménez-Canizales Heriberto Vásquez-Serna Jesús Alberto Garzón-Ramírez José Fair Alarcón-Robayo Juan Alexander Cerón-Pineda Alfonso J. Rodríguez-Morales |
| author_facet | Jaime A. Cardona-Ospina Carlos E. Jiménez-Canizales Heriberto Vásquez-Serna Jesús Alberto Garzón-Ramírez José Fair Alarcón-Robayo Juan Alexander Cerón-Pineda Alfonso J. Rodríguez-Morales |
| author_sort | Jaime A. Cardona-Ospina |
| collection | DOAJ |
| description | The febrile patient from tropical areas, in which emerging arboviruses are endemic, represents a diagnostic challenge, and potential co-infections with other pathogens (i.e., bacteria or parasites) are usually overlooked. We present a case of an elderly woman diagnosed with dengue, chikungunya and <i>Leptospira interrogans</i> co-infection. Study Design: Case report. An 87-year old woman from Colombia complained of upper abdominal pain, arthralgia, myalgia, hyporexia, malaise and intermittent fever accompanied with progressive jaundice. She had a medical history of chronic heart failure (Stage C, New York Heart Association, NYHA III), without documented cardiac murmurs, right bundle branch block, non-valvular atrial fibrillation, hypertension, and chronic venous disease. Her cardiac and pulmonary status quickly deteriorated after 24 h of her admission without electrocardiographic changes and she required ventilatory and vasopressor support. In the next hours the patient evolved to pulseless electrical activity and then she died. Dengue immunoglobulin M (IgM), non-structural protein 1 (NS1) enzyme-linked immunosorbent assay (ELISA), microagglutination test (MAT) for <i>Leptospira interrogans</i> and reverse transcription polymerase chain reaction (RT-PCR) for chikungunya, were positive. This case illustrates a multiple co-infection in a febrile patient from a tropical area of Latin America that evolved to death. |
| first_indexed | 2024-04-13T07:54:51Z |
| format | Article |
| id | doaj.art-7585a16f7f5d4bfb8ab0c943f563045b |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-04-13T07:54:51Z |
| publishDate | 2018-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-7585a16f7f5d4bfb8ab0c943f563045b2022-12-22T02:55:27ZengMDPI AGTropical Medicine and Infectious Disease2414-63662018-11-013412310.3390/tropicalmed3040123tropicalmed3040123Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical AreasJaime A. Cardona-Ospina0Carlos E. Jiménez-Canizales1Heriberto Vásquez-Serna2Jesús Alberto Garzón-Ramírez3José Fair Alarcón-Robayo4Juan Alexander Cerón-Pineda5Alfonso J. Rodríguez-Morales6Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira 66003, ColombiaPublic Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira 66003, ColombiaSecretary of Health of Ibagué, Ibague, Tolima 730001, ColombiaSchool of Medicine, Faculty of Health Sciences, Universidad de Tolima, Ibagué, Tolima 730001, ColombiaSecretary of Health of Tolima, Ibague, Tolima 730001, ColombiaSchool of Medicine, Faculty of Health Sciences, Universidad de Tolima, Ibagué, Tolima 730001, ColombiaPublic Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira 66003, ColombiaThe febrile patient from tropical areas, in which emerging arboviruses are endemic, represents a diagnostic challenge, and potential co-infections with other pathogens (i.e., bacteria or parasites) are usually overlooked. We present a case of an elderly woman diagnosed with dengue, chikungunya and <i>Leptospira interrogans</i> co-infection. Study Design: Case report. An 87-year old woman from Colombia complained of upper abdominal pain, arthralgia, myalgia, hyporexia, malaise and intermittent fever accompanied with progressive jaundice. She had a medical history of chronic heart failure (Stage C, New York Heart Association, NYHA III), without documented cardiac murmurs, right bundle branch block, non-valvular atrial fibrillation, hypertension, and chronic venous disease. Her cardiac and pulmonary status quickly deteriorated after 24 h of her admission without electrocardiographic changes and she required ventilatory and vasopressor support. In the next hours the patient evolved to pulseless electrical activity and then she died. Dengue immunoglobulin M (IgM), non-structural protein 1 (NS1) enzyme-linked immunosorbent assay (ELISA), microagglutination test (MAT) for <i>Leptospira interrogans</i> and reverse transcription polymerase chain reaction (RT-PCR) for chikungunya, were positive. This case illustrates a multiple co-infection in a febrile patient from a tropical area of Latin America that evolved to death.https://www.mdpi.com/2414-6366/3/4/123denguechikungunya<i>Leptospira</i>co-infectionColombiaLatin America |
| spellingShingle | Jaime A. Cardona-Ospina Carlos E. Jiménez-Canizales Heriberto Vásquez-Serna Jesús Alberto Garzón-Ramírez José Fair Alarcón-Robayo Juan Alexander Cerón-Pineda Alfonso J. Rodríguez-Morales Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas Tropical Medicine and Infectious Disease dengue chikungunya <i>Leptospira</i> co-infection Colombia Latin America |
| title | Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas |
| title_full | Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas |
| title_fullStr | Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas |
| title_full_unstemmed | Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas |
| title_short | Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas |
| title_sort | fatal dengue chikungunya and leptospirosis the importance of assessing co infections in febrile patients in tropical areas |
| topic | dengue chikungunya <i>Leptospira</i> co-infection Colombia Latin America |
| url | https://www.mdpi.com/2414-6366/3/4/123 |
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