1. Case Series of Fatal Leptospira spp./Dengue Virus Co-Infections—Puerto Rico, 2010–2012
- Author
-
Tyler M. Sharp, José V. Torres, Renee L. Galloway, Rita M. Traxler, Aidsa Rivera, Brenda Rivera Garcia, Kay M. Tomashek, David Noyd, Dianna M. Blau, Xavier E. Santiago-Albizu, William A. Bower, Julu Bhatnagar, Sherif R. Zaki, and Nicole M. Pérez Rodríguez
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,Dengue virus ,medicine.disease_cause ,Dengue fever ,Dengue ,Young Adult ,Fatal Outcome ,Leptospira ,Virology ,Internal medicine ,medicine ,Humans ,Leptospirosis ,Young adult ,Aged ,biology ,business.industry ,Coinfection ,Puerto Rico ,Articles ,Dengue Virus ,Middle Aged ,biology.organism_classification ,medicine.disease ,Anti-Bacterial Agents ,Infectious Diseases ,Immunology ,Parasitology ,Steroids ,business ,Co infection - Abstract
Co-infection with pathogens that cause acute febrile illness creates a diagnostic challenge as a result of overlapping clinical manifestations. Here, we describe four fatal cases of Leptospira species/dengue virus co-infection in Puerto Rico. Although all patients sought care early, antibiotic administration was delayed for most. Steroids were administered to all patients, in most cases before antibiotics. These cases show the need for clinicians evaluating patients in or recently returned from the tropics with acute febrile illness to consider both dengue and leptospirosis. Furthermore, they illustrate the need for nucleic acid- or antigen-based rapid diagnostic tests to enable timely patient diagnosis and management. In particular, antibiotic therapy should be initiated early for patients with suspected leptospirosis, and steroids should not be administered to patients with suspected dengue.
- Published
- 2014