%0 Journal Article
%T Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas
%A Alfonso J. Rodr¨ªguez-Morales
%A Carlos E. Jim¨¦nez-Canizales
%A Heriberto V¨¢squez-Serna
%A Jaime A. Cardona-Ospina
%A Jes¨²s Alberto Garz¨®n-Ram¨ªrez
%A Jos¨¦ Fair Alarc¨®n-Robayo
%A Juan Alexander Cer¨®n-Pineda
%J -
%D 2018
%R https://doi.org/10.3390/tropicalmed3040123
%X Abstract 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. View Full-Tex
%K dengue
%K chikungunya
%K Leptospira
%K co-infection
%K Colombia
%K Latin America
%U https://www.mdpi.com/2414-6366/3/4/123