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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 L...

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Autores principales: Cardona-Ospina, Jaime A., Jiménez-Canizales, Carlos E., Vásquez-Serna, Heriberto, Garzón-Ramírez, Jesús Alberto, Alarcón-Robayo, José Fair, Cerón-Pineda, Juan Alexander, Rodríguez-Morales, Alfonso J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306852/
https://www.ncbi.nlm.nih.gov/pubmed/30486238
http://dx.doi.org/10.3390/tropicalmed3040123
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author Cardona-Ospina, Jaime A.
Jiménez-Canizales, Carlos E.
Vásquez-Serna, Heriberto
Garzón-Ramírez, Jesús Alberto
Alarcón-Robayo, José Fair
Cerón-Pineda, Juan Alexander
Rodríguez-Morales, Alfonso J.
author_facet Cardona-Ospina, Jaime A.
Jiménez-Canizales, Carlos E.
Vásquez-Serna, Heriberto
Garzón-Ramírez, Jesús Alberto
Alarcón-Robayo, José Fair
Cerón-Pineda, Juan Alexander
Rodríguez-Morales, Alfonso J.
author_sort Cardona-Ospina, Jaime A.
collection PubMed
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 Leptospira interrogans 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 Leptospira interrogans 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.
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spelling pubmed-63068522019-01-02 Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas Cardona-Ospina, Jaime A. Jiménez-Canizales, Carlos E. Vásquez-Serna, Heriberto Garzón-Ramírez, Jesús Alberto Alarcón-Robayo, José Fair Cerón-Pineda, Juan Alexander Rodríguez-Morales, Alfonso J. Trop Med Infect Dis Case Report 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 Leptospira interrogans 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 Leptospira interrogans 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. MDPI 2018-11-26 /pmc/articles/PMC6306852/ /pubmed/30486238 http://dx.doi.org/10.3390/tropicalmed3040123 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Cardona-Ospina, Jaime A.
Jiménez-Canizales, Carlos E.
Vásquez-Serna, Heriberto
Garzón-Ramírez, Jesús Alberto
Alarcón-Robayo, José Fair
Cerón-Pineda, Juan Alexander
Rodríguez-Morales, Alfonso J.
Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas
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 Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306852/
https://www.ncbi.nlm.nih.gov/pubmed/30486238
http://dx.doi.org/10.3390/tropicalmed3040123
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