Management of dengue with co-infections: an updated narrative review

Abstract

Dengue, co-infection, management, approach, atypical Dengue Dengue is a life-threatening mosquito borne viral disease. We are still in the era of supportive treatment where morbidity and mortality are a major concern. Dengue infection in presence of other co-infections makes this scenario rather worse. Timely recognition and raising alarm to be intensive is the need of the hour for primary care physicians practicing in the community and indoors. This review provides a comprehensive knowledge about the recent trends of coinfection in dengue as well as their management consideration which will be particularly helpful for physicians practicing in rural and remote areas of India.

Concurrent Dengue-Malaria Infection: The Importance of Acute Febrile Illness in Endemic Zones

“…However, overlapping epidemiology, vector distribution, pathogen cocirculation in the same geographic areas, and even initial clinical manifestations; makes it difficult to identify cases of concurrent infections. 11 , 12 Hence, having a high index of clinical suspicion for concurrent infection is essential to make a timely diagnosis and administration of the specific treatment required. 9 Revised literature mentioned that dengue fever should be suspected if a patient presents with bleeding manifestations, retrobulbar headache, severe myalgias, and/or thrombocytopenia.…”

“… 9 Revised literature mentioned that dengue fever should be suspected if a patient presents with bleeding manifestations, retrobulbar headache, severe myalgias, and/or thrombocytopenia. 8 - 13 If suspected, the possibility of mixed infections with various Plasmodium species should be excluded to ensure a better treatment outcome. 8 - 13 …”

“… 8 - 13 If suspected, the possibility of mixed infections with various Plasmodium species should be excluded to ensure a better treatment outcome. 8 - 13 …”

“… 3 Immune-mediated or direct interactions in concurrent VTE infections could enhance or inhibit the progression of both infections. 11 The diagnosis of 1 type of infection should not exclude the presence of another whose treatment could be ignored or, at least, delayed. 10 , 11 …”

Leptospirosis and Coinfection: Should We Be Concerned?

“…Treatment with antibiotics must be initiated as soon as a provisional diagnosis of leptospirosis is suspected, regardless of the length of the symptom [92]. Furthermore, most of the coinfected patients respond effectively to fluid therapy, doxycycline and closely monitoring of their platelet count and hematocrit [93,94]. However, in some leptospirosis coinfections, treatment could not be assessed due to the lack of data, and it is critical to determine these different of infections that can provide relevant treatment decisions for patients with coinfections [95].…”