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Introduction: Rapid antigen testing can help in early diagnosis of Influenza in resource limited settings in patients presenting with Influenza Like Illness (ILI). Aim: To evaluate the usefulness of Rapid Influenza Direct antigen Testing (RIDT) in comparison to Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) for diagnosis of Influenza virus infection in clinically suspected patients with ILI in a tertiary care hospital. Material and Methods: A prospective observational independent study was done to evaluate RIDT for Influenza virus infection, considering RT-PCR as gold standard. Throat swabs and nasal swabs from patients meeting Category 3 definition of ILI by Ministry Of Health and Family Welfare (MOHFW) were collected from July 20th, 2019 to October 20th, 2019 from hospitals in and around the study area. Onsite Rapid test (Biogenix, China) was used as per manufactures instructions for rapid detection of Influenza antigen. RNA extraction was done using Qiagen kit followed by RT-PCR using primer, probes recommended by National Institute of Virology (NIV, Pune) as per their protocols. Data was recorded on a predesigned proforma and managed using Microsoft Excel 2018 (Microsoft Corp, Redmond, WA). The Statistical software MedCalc version 9.1 for Windows was used for data analysis. Results: The overall sensitivity of the RIDT was 37.9% and specificity was 94.4%. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were 73.3% and 78.8%, respectively. Kappa was calculated to be 0.37 that suggested a fair agreement between RIDT and RT-PCR. When the Cycle threshold (Ct) values were compared to the results of RIDT, there were more false positives at low Ct value and more false negatives at high Ct values. Conclusion: The RIDT is not useful in screening during an outbreak in acute care settings. The negative result of RIDT should be followed up with RT-PCR. With a strong clinical suspicion, it is better to start antivirals than wait for laboratory report in severely ill patients with ILI.

Background: The present study was designed to know the trends of acute phase dengue in the Rayalaseema region of Andhra Pradesh state. Methods: This was a retrospective study conducted at Sri Venkateswara Institute of Medical Sciences, a tertiary care teaching hospital in Tirupati, Andhra Pradesh. Samples received for dengue NS1 testing from January 2011 to December 2015 were analysed. Results: During the study period, 6182 serum samples were received from cases clinically suspected to have dengue fever. Of these 690 (11.2%) tested positive. Positivity was significantly higher among females compare to males (12.1% vs 10.4%; P = 0.037). Children (19.2%) were more affected than adults (12.2%) and elderly (3.6%) (P < 0.001). Conclusion: Acute dengue infections were high in children compared to other age-groups with preponderance during post-monsoon and monsoon periods.

Introduction: Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are serious public health problems worldwide with estimated 350 million chronically infected people. Transmission of infection occurs through blood transfusion, needles, body fluids and sexual intercourse. To know the magnitude of transmission of any disease in a community and for its control and prevention; trend and study of its prevalence is most important. Aim: To analyse the overall trend of HBV and HCV infection and to estimate the seroprevalence in a tertiary care hospital of Southern India. Materials and Methods: This was a retrospective study conducted at the Department of Microbiology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati, Andhra Pradesh, India. The data of 77,158 and 58,024 samples for the test of Hepatitis B surface antigen (HBsAg) and test for anti-hepatitis C antibody respectively, for a period of three years four months (from September 2013 to December 2016) was retrieved from Departmental registers and Hospital Information System. Statistical software IBM SPSS, Version 20.0 (IBM SPSS Statistic, Somers NY, USA) was used for statistical analysis. Results: A total of 77,158 samples were tested for HBsAg whereas, 58,024 were tested for the presence of anti-HCV antibody. Seroprevalence of HBV was 2.27% and for HCV, it was 0.73%. Conclusion: HBV infection is showing a decreasing trend and the HCV infection, a fluctuating trend. Attempt should be made to reduce the incidence of HBV and HCV by simple preventive measures like public education, screening of blood and blood products, increasing public awareness about importance of vaccination.

Background and Objectives: Influenza virus is a typical human pathogen causing serious respiratory illness resulting in significant mortality throughout the globe. Andhra Pradesh witnessed the first case of influenza A H1N1 in India from Hyderabad (now in Telangana) on May 16, 2009. In the recent past, Andhra Pradesh witnessed exponential increase in the number of confirmed cases of influenza infection. In this study, we present the salient features of the recent outbreak of influenza during 2017–2018 in the state of Andhra Pradesh, first of its kind after the division of the state. Materials and Methods: Clinically, suspected cases of influenza-like illness received in the Virus Research and Diagnostic Laboratory, Department of Microbiology, Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati, from January 2017 to May 2018 were included in the study. The samples were tested for influenza A, influenza A (H1N1) pdm09, influenza A (H3N2), influenza B, influenza B/Yamagata and influenza B/Victoria. Results: A total of 1286 samples were received for testing. The positive samples were influenza A unsubtypable (109), influenza A (H1N1) pdm09 (356), influenza A (H3N2) (38) and influenza B (19; Victoria - 2, Yamagata - 17). There was no significant difference in positivity between genders with 260 (49.81%) females and 262 (50.19%) males being positive. Conclusion: The outbreak started in the late monsoon (January) of 2017 and had two peaks; one in summer months and another in winter months. Influenza B virus was reported from December 2017 to May 2018. Age groups ≤5 years and 6–18 years had higher positivity as compared to other age groups. Regular surveillance programmes are required for assessing the trends of influenza infections due to various subtypes and to plan timely and adequate steps for preventing the spread to larger vulnerable population.

Background: Respiratory tract infections are a common occurrence after open heart surgery, leading to prolonged hospital stay, morbidity and costing the hospital exchequer. This study was conducted to study the utility of postextubation endotracheal tube [ET] tip culture in providing an early-basis for starting evidence-based antibiotic therapy. Methods: We retrospectively reviewed the case records of 172 patients who had undergone heart surgery at our tertiary care teaching hospital for occurrence of post-operative infections from clinical and microbiological data. Results: Bacterial culture was positive in 67(39%) patients. Endotracheal tube patients, grew organisms that were sensitive to empirical antibiotic therapy, in 39 (58%) patients. In 28 (42%) patients organisms resistant to empirical therapy were grown; only 14 of the 28 patients (50%) were symptomatic. Staphylococcus was the most common organism isolated followed by Acinetobacter and Enterobacter. Pseudomonas aeruginosa isolates were sensitive to all the antibiotics tested. Resistance was high among Acinetobacter sp. All the Gram-negative bacteria were sensitive to tigecycline. Resistance for beta-lactam antibiotics ranged from 35%-66% with imipenem being the most effective antibiotic. Conclusion: Our observations provide useful information regarding the microbiology of respiratory infection occurring in post-operative patients who had undergone open-heart surgery. Post-extubation endotracheal tip culture appears to be a useful tool for reliable and accurate diagnosis and treatment of these infections.

Fungal infections are a common cause of morbidity and mortality among patients on continuous ambulatory peritoneal dialysis (CAPD). We present the clinical manifestations, and management of five CAPD patients with fungal peritonitis seen during the last seven years. Microscopy and culture of the peritoneal fluid tested positive for fungus in all patients. Filamentous fungi were identified as the causative fungi among four patients and Candida nonalbicans was the cause in one patient. Catheter was removed and appropriate antifungal therapy was given to all the patients. Four patients recovered and one died due to ventilator associated infection. Previously treated bacterial infections, old age more than 50 years, diabetes and hypertension were recognised as the risk factors leading to fungal infection among CAPD patients.

Rhytidhysteron is a saprophytic dematiaceous fungus which rarely infects humans. Though virtually all individuals are exposed, very few develop the disease. Only seven human cases are reported till date. The present case is the second case from South India. A 40-year-old immunocompetent female agricultural worker, presented with a swelling on the dorsum of the right hand. Fine needle aspiration cytology (FNAC) of the swelling revealed short, thick, branched septate fungal hyphae. The isolate was moderately slow growing; grayish white colonies were observed on Sabouraud's Dextrose Agar (SDA) slant. On further incubation, the colonies turned floccose, greyish black and the black pigment was observed on the reverse. Microscopy of lactophenol cotton blue tease mount showed thick, brown septate hyphae without any fruiting bodies. Molecular typing confirmed the isolates as Rhytidhysteron rufulum. Identification of all clinical isolates of nonsporulating fungi to genus level is necessary to identify rare fungi infecting humans.

Background & objectives: Ventilator-associated pneumonia (VAP) is an important hospital-acquired infection with substantial mortality. Only a few studies are available from India addressing the microbiological aspects of VAP, which have been done with small study populations. This study was carried out in the intensive care units (ICUs) of a tertiary care hospital to assess the profile of pathogens and to determine the pattern of antimicrobial resistance. Methods: This was a retrospective study of clinically suspected cases of VAP. Over a three year period, a total of 247 cases in 2011, 297 in 2012 and 303 in 2013 admitted in ICUs on mechanical ventilation with clinical evidence of VAP were included in our study. The endotracheal aspirate samples from these suspected cases were subjected to quantitative culture technique, and colony count of ≥10[5] colony forming units/ml was considered significant. Antimicrobial susceptibility test for the isolates was done. Results: VAP rates of 44.1, 43.8 and 26.3 were seen in 2011, 2012 and 2013, respectively. In all the three years, non-fermentative Gram-negative bacilli were the predominant organisms, followed by Pseudomonas spp. and Klebsiella spp. Staphylococcus aureus exhibited a downwards trend in prevalence from 50.0 per cent in 2011 to 34.9 per cent in 2013. An increase in vancomycin-resistant enterococci was seen from 4.3 per cent in 2012 to 8.3 per cent in 2013, while methicillin resistance amongst the S. aureus crossed the 50 per cent mark in 2013. An increasing trend in resistance was shown by Pseudomonas spp. for piperacillin-tazobactam (PTZ), amikacin and imipenem (IPM). For the non-fermenters, resistance frequency remained very high except for IPM (33.1%) and polymyxin-B (2.4%). Interpretation & conclusions: Our findings show VAP as an important problem in the ICU setting. The incidence of multidrug-resistant pathogens was on the rise. The resistance pattern of these pathogens can help an institution to formulate effective antimicrobial policy. To have a comprehensive pan-India picture, multicentric studies are needed.

Background: Safe blood donation remains a challenge in resource limited countries. False positive serological tests lead to wastage of large number of blood units. Nucleic acid amplification test (NAAT) technology has greatly enhanced the accuracy in identification of transfusions transmitted infections. Methods: The present study was undertaken to study the seroprevalence of hepatitis C virus (HCV) and asses the concordance between seropositivity with the presence of HCV ribonucleic acid (RNA) and to know the distribution pattern of HCV genotypes in healthy blood donors. Results: Among the 9287 donors screened (88.3% males), 7153 (77%) were voluntary donors while 2134 (23%) were replacement donors. Among blood donors, 27 (0.3%) samples tested HCV seropositive. Among 27 anti-HCV positive samples only 11 (41%) were found positive for HCV RNA. Among the 5 samples subjected to sequencing, three were found to be genotype 1a while two were genotype 3a. Conclusions: Our observations suggest that implementing NAAT test for HCV screening will be helpful in minimizingfalse-positive test results in the Indian setting.

Introduction: Continuous Ambulatory Peritoneal Dialysis (CAPD) is a well established treatment modality for End Stage Renal Disease (ESRD) which has advantages in providing mobility and more independence to the patient but at the same time some complication are more commonly associated with it. Fungal Peritonitis (FP) is one of such complications which although rare, is a serious concern with failure of the technique and fatal outcome. Aim: To analyse the incidence, associated risk factors and the outcome of FP in CAPD patients. Materials and Methods: This was a ten year (2008-2017) retrospective study conducted on 180 ESRD patients who were on continuous ambulatory peritoneal dialysis. Case sheets were retrieved from medical record department section and data was analysed. Results: The incidence of FP was 10%, with female’s preponderance (55.5%). The most common fungus isolated was Candida albicans in 61.1% patients (11), followed by Aspergillus niger 22.2% (4), Curvularia lunata 11.1% (2) and Fusarium spp in 5.5% (1) in descending order. On the diagnosis of FP, catheter was removed immediately and the patient was treated appropriately. Re-insertion was done in 22.2% of patients, whereas 33.3% patients were shifted to haemodialysis and 44.4% patients expired. Filamentous fungi were the cause for 75% of the mortality. Conclusion: Candida spp remains the most common cause of FP but filamentous fungi are more commonly associated with fatal outcome.

Introduction: Scrub typhus is a rickettsial infection which is caused by Orientia tsutsugamushi and transmitted by the bite of the chigger of a mite. Delay in diagnosis can be fatal otherwise the treatment is simple, doxycycline being the drug of choice. Indirect immunoflurescence is considered gold standard but it is not used in India as it is costly and also not available. There is need for rapid, economic and simple test for the diagnosis of scrub typhus. This study was taken up to study the seroprevalence of scrub typhus in Andhra Pradesh and to compare two commonly used serological methods; rapid test and IgM ELISA. Materials and methods: This is a prospective study in which 100 serum samples from clinically suspected cases collected over a period of 3 months were processed for the detection of IgM antibodies for scrub typhus by ELISA and Rapid test. Samples were also tested for leptospirosis and dengue fever which the other common causes of fever prevalent in this region. Results: Total number of samples processed was 100 of which 52 were males and 48 females. Among the hundred samples 39 were seropositive. Positivity was higher in the age group of patients between 16 and 30 yrs of age. There was 97% correlation between ELISA and rapid method. Of the 100 samples only three samples positive by ELISA were negative by rapid method. Fever was the most common manifestation and there was no eschar and no mortality reported. Conclusion: Scrub typhus should be included in the differential diagnosis of fever of unknown origin along with dengue, malaria and leptospirosis which are the other common endemic infections in this part of the country.

Background: Detection of antinuclear antibody (ANA) is used as one of the diagnostic criteria for autoimmune rheumatic diseases (ARD). Both indirect immunofluorescence (IIF) and enzyme linked immunosorbant assay (ELISA) methods are used for this purpose. However, there are lack of data comparing these two tests from India. Methods: We prospectively studed 294 patients clinically suspected to be having ARD between April 2012 and September 2013. They were tested for ANA by IIF and ELISA methods. Representative samples positive by both the tests were processed again by a line immunoassay test to detect the specific antinuclear antibodies. Considering the IIF results as the ‘gold standard’, the utility of ELISA for ANA detection was analyzed. Results: Of the 294 samples processed, 181 (61.5%) were from female patients. By IIF 30% of samples in males and 40.3% sample in females tested positive. We found ELISA to have a poor sensitivity (45.8%) but good specificity (99.5%). The positive predictive value for ELISA were 98% and negative predictive value 76.2% respectively. Forty four samples positive by both IIF and ELISA were tested by Western blot to detect individual autoantibodies. Of these, only 24 samples showed the presence of one or more bands, while the remaining 20 (45.4%) were negative by line immunoassay. In our study anti-nuclear ribonucleoprotein/Smith was the most common ANA detected. Conclusions: The poor sensitivity raises concerns regarding the practice of initial screening for ANA by ELISA.

Fungal peritonitis is an uncommon condition which is associated with high morbidity and mortality in patients on continuous ambulatory peritoneal dialysis (CAPD). It is associated with several complications and many of the patients who develop this condition are unable to resume CAPD treatment and have to shift to haemodialysis. Here we report the rare occurrence of fungal peritonitis due to Aspergillus niger in a patient on CAPD.

Background: Infections are the main reason for hospitalization and the second common cause of death in chronic kidney disease (CKD) patients. Infections develop primarily as a consequence of deranged innate immunity. In this study, we assessed the efficiency of phagocytic function of polymorphonuclear (PMN) leukocytes in severe CKD patients. Aims and Objectives: The aims of the study were (i) to assess the phagocytic index and lytic index of PMN leukocytes (PMNLs) in Stages 4 and 5 CKD patients. (ii) To compare the above indices with healthy age and sex-matched controls. Materials and Methods: The study was carried out in 60 adults in the age group of 18–60 years of which 30 were CKD patients in Stages 4 and 5 taking conservative treatment (not on dialysis) and other 30 were age and sex-matched controls. After screening for inclusion and exclusion criteria, 5 ml of venous blood was collected and taken immediately for evaluation. Phagocytic index which is the number of neutrophils positive for ingested microbes per 100 neutrophils and lytic index which is the total number of microbes per 100 cells were calculated. These are indices of neutrophil functioning. Results: Statistically significant decrease in both phagocytic index and lytic index were found in Stages 4 and 5 CKD patients as compared to controls. Conclusion: In the present study, we were able to establish that phagocytic capacity of PMNLs is adversely affected in severe CKD patients. This gains importance in the light of immune dysfunction being considered as a major cause of premature deaths resulting from infections in severe CKD.

Background & objectives: Dengue virus infection is endemic in India with all the four serotypes of dengue virus in circulation. This study was aimed to determine the geographic distribution of the primary and secondary dengue cases in India. Methods: A multicentre cross-sectional study was conducted at Department of Health Research / Indian Council of Medical Research (DHR)/(ICMR) viral research and diagnostic laboratories (VRDLs) and selected ICMR institutes located in India. Only laboratory-confirmed dengue cases with date of onset of illness less than or equal to seven days were included between September and October 2017. Dengue NS1 antigen ELISA and anti-dengue IgM capture ELISA were used to diagnose dengue cases while anti-dengue IgG capture ELISA was used for identifying the secondary dengue cases. Results: Of the 1372 dengue cases, 897 (65%) were classified as primary dengue and 475 (35%) as secondary dengue cases. However, the proportion varied widely geographically, with Theni, Tamil Nadu; Tirupati, Andhra Pradesh and Udupi-Manipal, Karnataka reporting more than 65 per cent secondary dengue cases while Srinagar, Jammu and Kashmir reporting as low as 10 per cent of the same. The median age of primary dengue cases was 25 yr [interquartile range (IQR 17-35] while that of secondary dengue cases was 23 yr (IQR 13.5-34). Secondary dengue was around 50 per cent among the children belonging to the age group 6-10 yr while it ranged between 20-43 per cent among other age groups. Interpretation & conclusions: Our findings showed a wide geographical variation in the distribution of primary and secondary dengue cases in India. It would prove beneficial to include primary and secondary dengue differentiation protocol in the national dengue surveillance programme.

Background: Shewanella spp. are unusual cause of disease in humans; however, reports of Shewanella infections have been increasing. Shewanella is a ubiquitous organism that has been isolated from many foods, sewage, and both from fresh and salt water. Earlier it was named as Pseudomonas putrefaciens or Shewanella putrefaciens. There are several reports describing this organism causing human infections such as cellulitis, abscesses, bacteremia, wound infection, etc. It is oxidase and catalase-positive non-fermenter gram-negative rod that produces hydrogen sulfide. Aims: The study was conducted to identify Shewanella spp., which was wrongly reported as Pseudomonas spp. Materials and Methods: Clinical samples were cultured as per standard clinical laboratory procedure. We tested the non-lactose-fermenting colonies for oxidase positivity. Oxidase-positive colony was inoculated in triple sugar iron slant (TSI) to know the hydrogen sulfide production. Hydrogen sulfide positive colonies were further tested for citrate, urease, indole, and amino acid decarboxylation and acid and gas production from sugars. Results: Five isolates identified as Pseudomonas spp. during preliminary testing were proved to be Shewanella spp. on further testing. Conclusions: It will help in better understanding the epidemiology, pathogenesis and risk factors associated with these and prevention of the rare pathogenic organisms.

Background: The present study was undertaken to know the contribution of four infectious causes of fever namely dengue, chikungunya, scrub typhus and malaria in patients presenting with fever of more than one week duration with thrombocytopenia in a tertiary care teaching hospital, Tirupati, Andhra Pradesh. Methods: In this prospective study, 1014 samples from different patients who presented with fever and of more than one week duration and thrombocytopenia were collected over a period of six months and were processed for the detection of non-structural 1 (NS1) glycoprotein antigen for dengue, immunoglobulin M (IgM) antibodies for leptospirosis and scrub typhus by ELISA and malaria parasite by quantitative buffy coat (QBC). Results: Among 1014 samples obtained from patients with fever with thrombocytopenia, 111 (10.94%) were due to thrombocytopenia due to infectious causes. Ninety (81.08%) were due to single infection and twenty one (18.92%) due to co-infections. Males were more affected. Peak incidence was in 40-49 years of age with scrub typhus as the predominant infection. Grade-3 thrombocytopenia was more common in all the four infections. Conclusions: Our observations suggest that scrub typhus was the predominant cause of fever with thrombocytopenia, along with dengue, leptospira and malaria. Diagnostic evaluation should include search for these causes in patients presenting with fever with thrombocytopenia. This can be helpful as both are easily treatable infections with commonly available oral antibiotics.

Fungal peritonitis, which was once a rare entity, is becoming increasingly common due to various immunocompromised conditions. Candida species are considered the common cause of fungal peritonitis in most cases. However, at present, other yeasts and filamentous fungi are replacing the dominance of Candida albicans as well as other Candida species. Trichosporon species are widely distributed in nature and are normal flora in the gastrointestinal tract of humans. Ever since the report of disseminated trichosporonosis in 1970, several cases of infections by various Trichosporon species in different clinical patients have been published. Here, we present a patient with Trichosporon peritonitis after duodenal perforation. To the best of our knowledge, this is the first case report of its kind from India.

Background: Fungal infections are gaining prominence in recent years and are becoming a cause of significant morbidity as well as mortality. Reliable data from India about the spectrum of pathogens causing fungal infection in various body systems, and particularly about the antifungal susceptibility pattern of Candida spp., which is the most common isolate worldwide is not available. Methods: We prospectively studied 48,155 clinical samples submitted for fungal work-up to the microbiology laboratory at our tertiary care teaching hospital. Standard procedures were followed for fungal identification. Candida isolates were differentiated into Candida albicans and non-albicans candida (NAC) by germ tube test. Antifungal susceptibility of Candida isolates was determined by disc diffusion technique using amphotericin B (10 μg), fluconazole (25 μg), and voriconazole (1 μg) discs. Results: A total of 555 fungal isolates were obtained of which 541 were Candida spp, while the others were filamentous fungi. Male gender and age over 50 years were found to be independent risk factors. Proportion of NAC isolates (n =384, 69.2%) were greater compared to C. albicans (n = 157, 28.3%). Aspergillus spp. was the second most frequent isolate. Azole resistance was significantly more in NAC group as compared to C. albicans. For fluconazole, 57.5% of the NAC showed resistance compared to 24.8% seen in strains of C. albicans while the corresponding figure for voriconazole was 56.8% Vs 22.9%. Overall resistance for amphotericin B was low (8.9%). Conclusions: Our observations bring to light the spectrum of common fungal isolates and their susceptibility patterns. This information will be useful for health planners and policy makers, as early institution of appropriate antifungal treatment can be life saving.

Several techniques are available for the diagnosis of leptospirosis and microscopic agglutination test is considered as gold standard, but these require sophisticated techniques and instruments. This study was conducted to know the sensitivity and specificity of dark field microscopy (DFM) as compared to IgM enzyme-linked immunosorbent assay (ELISA) in correlation with clinical diagnosis. It is a prospective study of 297 samples received from clinically suspected cases of leptospirosis for DFM and IgM ELISA. We tried to evaluate the easily available technique, DFM. We got promising results with DFM. Specificity and sensitivity were observed to be 61% and 60%, respectively, alone and 95.8% efficacy when combined with IgM ELISA. Thus, DFM should be tried for where other diagnostic tools are not easily available. It is an easy and rapid technique, which can help in the early diagnosis and management of patients.

The differentiation of sepsis and systemic bacterial infections from other causes of systemic inflammatory response is crucial from the therapeutic point of view. The clinical signs and symptoms are non-specific and traditional biomarkers like white cell count, erythrocyte sedimentation rate and C-reactive protein are not sufficiently sensitive or specific to guide therapeutic decisions. Procalcitonin (PCT) is considered a reliable marker for the diagnosis and prognosis of moderate to severe bacterial infections, and it has also been evaluated to guide the clinicians in the rational usage of antibiotics. This review describes the diagnostic and prognostic role of PCT as a biomarker in various clinical settings along with the laboratory aspects and its usefulness in risk stratification and antibiotic stewardship.

Introduction: Leptospirosis is a zoonosis with a worldwide distribution affecting almost 160 mammalian species. Dengue, one of the major mosquito-borne arboviral infections of humans is caused by any of the four serologically related viruses designated as DENV-1, DENV-2, DENV-3, and DENV-4. In the presentation of these two diseases, there exists similarity, which may result in the possibility of coinfection. The present study is carried out to confirm our hypothesis. Materials and Methods: The samples which were received from the clinically suspected cases of leptospirosis and dengue for a period of 3 years. All others with definitive alternate diagnosis were not included for the study. Samples were tested for immunoglobulin M (IgM) antibodies using Serion-virion (virion\Serion classic; Institut Virion Serion GmbH, Warburg, Germany) and PanBio IgM antibody-capture (MAC) ELISA (PanBio Inc., Brisbane, Australia) kit as per the instructions provided and the results were interpreted according to the manufacturer. Discussion and Results: In present study, there were 21.41% cases of leptospirosis, 11.2% cases of dengue fever, and 3.6% of cases were co infective. Conclusion: The present study emphasizes that in fewer cases; there may be a possibility of coinfection with leptospirosis and dengue. Therefore, high index of clinical suspicion is required so as to constitute appropriate therapy to reduce the mortality rate.