Leptospirosis coexistent with dengue fever: A diagnostic dilemma

Mishra, Baijayantimala; Singhal, Lipika; Sethi, Sunil; Ratho, Radha Kanta

doi:10.4103/0974-777x.116878

Cited by 18 publications

(5 citation statements)

References 3 publications

(7 reference statements)

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“…In the present study, we found seven leptospirosis patients to be co-infected with dengue and one with scrub typhus. Leptospirosis co-infection with dengue or scrub typhus is commonly seen in neighbouring countries such as Thailand and India [36][37][38][39][40][41][42][43]. Dengue is highly endemic in Malaysia with a minimum of 100,000 cases and more than 200 mortalities every year [44].…”

Section: Discussionmentioning

confidence: 99%

Leptospira interrogans and Leptospira kirschneri are the dominant Leptospira species causing human leptospirosis in Central Malaysia

et al. 2020

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Background Leptospirosis, commonly known as rat-urine disease, is a global but endemic zoonotic disease in the tropics. Despite the historical report of leptospirosis in Malaysia, the information on human-infecting species is limited. Determining the circulating species is important to understand its epidemiology, thereby to strategize appropriate control measures through public health interventions, diagnostics, therapeutics and vaccine development. Methodology/Principle findings We investigated the human-infecting Leptospira species in blood and serum samples collected from clinically suspected leptospirosis patients admitted to three tertiary care hospitals in Malaysia. From a total of 165 patients, 92 (56%) were confirmed cases of leptospirosis through Microscopic Agglutination Test (MAT) (n = 43; 47%), Polymerase Chain Reaction (PCR) (n = 63; 68%) or both MAT and PCR (n = 14; 15%). The infecting Leptospira spp., determined by partial 16S rDNA (rrs) gene sequencing revealed two pathogenic species namely Leptospira interrogans (n = 44, 70%) and Leptospira kirschneri (n = 17, 27%) and one intermediate species Leptospira wolffii (n = 2, 3%). Multilocus sequence typing (MLST) identified an isolate of L. interrogans as a novel sequence type (ST 265),

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Section: Discussionmentioning

confidence: 99%

Leptospira interrogans and Leptospira kirschneri are the dominant Leptospira species causing human leptospirosis in Central Malaysia

et al. 2020

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“…Self-limiting fever can lead to dengue shock syndrome or fatal dengue hemorrhagic fever. Leptospirosis and dengue may coexist in large numbers due to similar environmental conditions; however, there are few documented cases [3].…”

Section: Introductionmentioning

confidence: 99%

Leptospirosis and Dengue Coinfection-Associated Multi-Organ Dysfunction Syndrome: A Case Report

Shiddapur,

Reddy,

Kondapalli

et al. 2024

Cureus

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Dengue and leptospirosis are frequently discussed separately, with dengue causing rash and leptospirosis causing jaundice. Currently, there are more and more reports of coinfections. The comparable clinical symptoms of both infections make it challenging to distinguish between leptospirosis and dengue. Differentiating between leptospirosis and dengue is crucial since leptospirosis has a more favorable prognosis with early antibiotic therapy, whereas dengue does not have a specific treatment, although early detection is essential for close monitoring and cautious fluid management. Here, we highlight a case of dengue virus and leptospirosis coinfection in a female who presented with acute febrile illness, dyspnea, and altered sensorium, which progressed to multiorgan dysfunction syndrome, involving the neurological, respiratory, hepatic, and hematological systems.

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“…Serological testing is cheaper but has less sensitivity. Confirmation using these techniques is often delayed because laboratories can be quickly overwhelmed during major outbreaks and rapid diagnostic tests (RDT) could be used instead but are not always available and may also have diagnosis accuracy discrepancies depending on their setting [ 7 , 8 ]. The objective of this study was to identify the clinical and biological factors associated to diagnosing leptospirosis that differentiate it to the detection of DF at hospital admission on the Reunion Island where the two diseases are endemic and epidemic.…”

Section: Introductionmentioning

confidence: 99%

“…During these epidemics, many concerns have been raised about the risk of confusion between leptospirosis and DF because the clinical-biological presentation during the acute phase of both diseases are often similar [6][7][8][9][10][11]. This confusion can be detrimental and carry a risk of delayed antibiotic treatment leading to increased mortality in leptospirosis patients [12][13][14], particularly when leptospirosis is misdiagnosed as DF [10,15].…”

Section: Introductionmentioning

confidence: 99%

C-reactive protein: An easy marker for early differentiation between leptospirosis and dengue fever in endemic area

Maillard,

Hirschinger,

Bénéteau

et al. 2023

PLoS ONE

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In tropical regions, leptospirosis and dengue fever (DF) are infectious diseases of epidemiological importance and have overlapping symptomatic features. The objective of this study was to identify the factors associated to diagnosing leptospirosis that differentiate it to DF at the initial hospital evaluation. A multicenter retrospective study was conducted comparing confirmed leptospirosis to DF cases. Clinical/laboratory findings were compiled at hospital admission on Reunion Island between 2018 and 2019. Multivariable logistic regression was used to identify the predictors of leptospirosis. In total, 98 leptospirosis and 673 DF patients were included with a mean age of 47.8 (±17.1) and 48.9 (±23.3) years, respectively. In the multivariate analyses, the main parameters associated with leptospirosis were: i) increased neutrophil counts, ii) C-reactive protein values, iii) the absence of prolonged partial thromboplastin time, and iv) a decrease of platelets. The most discriminating parameter was C-reactive protein (CRP). With a threshold of 50mg/L, CRP taken alone had a sensitivity of 94% and a specificity of 93.5%. The positive and negative likelihood ratios were 14.5 and 0.06, respectively. In the setting of an early presumptive diagnosis, we found that an increased CRP value (>50 mg/L) could help diagnose leptospirosis and aid the decision process for hospital surveillance and/or a potential antibiotic treatment regimen.

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Leptospirosis coexistent with dengue fever: A diagnostic dilemma

Cited by 18 publications

References 3 publications

Leptospira interrogans and Leptospira kirschneri are the dominant Leptospira species causing human leptospirosis in Central Malaysia

Leptospira interrogans and Leptospira kirschneri are the dominant Leptospira species causing human leptospirosis in Central Malaysia

Leptospirosis and Dengue Coinfection-Associated Multi-Organ Dysfunction Syndrome: A Case Report

C-reactive protein: An easy marker for early differentiation between leptospirosis and dengue fever in endemic area

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