Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Fatal Dengue, Chikungunya and Leptospirosis Co-Infection: The Febrile Patient in Tropical Areas, Importance of Co-Infection Assessment

Jaime A. Cardona-Ospina
ORCID logo ,
Carlos E. Jimenez-Canizales
,
Heriberto Vasquez-Serna
,
Jesús Alberto Garzon-Ramirez
,
Jose Fair Alarcon-Robayo
,
Juan Alexander Cerón-Pineda
,
Alfonso J. Rodriguez-Morales
* ORCID logo
Version 1 : Received: 6 November 2018 / Approved: 12 November 2018 / Online: 12 November 2018 (03:21:38 CET)

A peer-reviewed article of this Preprint also exists.

Cardona-Ospina, J.A.; Jiménez-Canizales, C.E.; Vásquez-Serna, H.; Garzón-Ramírez, J.A.; Alarcón-Robayo, J.F.; Cerón-Pineda, J.A.; Rodríguez-Morales, A.J. Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas. Trop. Med. Infect. Dis. 2018, 3, 123. Cardona-Ospina, J.A.; Jiménez-Canizales, C.E.; Vásquez-Serna, H.; Garzón-Ramírez, J.A.; Alarcón-Robayo, J.F.; Cerón-Pineda, J.A.; Rodríguez-Morales, A.J. Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas. Trop. Med. Infect. Dis. 2018, 3, 123.

Abstract

Background: The febrile patient from tropical areas, in which emerging arboviruses are endemic, represent a diagnostic challenge and potential co-infections with other pathogens (i.e bacteria or parasites) are usually overlooked. Objectives: We present a case of an elderly woman diagnosed with dengue, chikungunya and Leptospira interrogans co-infection. Study Design: Case report. Results: 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, 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 hours 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 IgM, NS1 ELISA, MAT for Leptospira interrogans and RT-PCR for chikungunya, were positive. Discussion: This case illustrates a multiple co-infection in a febrile patient from a tropical area of Latin America that evolved to death.

Keywords

dengue; chikungunya; Leptospira; co-infection; Colombia; Latin America

Subject

Medicine and Pharmacology, Tropical Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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