1Division of Infectious Disease, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
2Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Am J Trop Med Hyg. 2020 Dec 15;104(2):487-489. doi: 10.4269/ajtmh.20-1340.
We report a 50-year-old Thai woman with recent travel to Denmark who presented with acute high-grade fever, vomiting, and myalgia for 1 day. Initial laboratory results revealed leukopenia, elevated aspartate transaminase, and elevated alanine transaminase. Chest radiograph showed no pulmonary infiltration. Reverse transcriptase-PCR (RT-PCR) of the nasopharyngeal swab detected SARS-CoV-2, and RT-PCR of the blood detected dengue virus serotype 2. COVID-19 with dengue fever co-infection was diagnosed. Her symptoms were improved with supportive treatment. Integration of clinical manifestations, history of exposure, laboratory profiles, and dynamic of disease progression assisted the physicians in precise diagnosis. Co-circulating and nonspecific presentations of dengue infection and COVID-19 challenge the healthcare system in tropical countries. To solve this threat, multi-sector strategies are required, including public health policy, development of accurate point-of-care testing, and proper prevention for both diseases.
我们报告了一位 50 岁的泰国女性,近期前往丹麦旅行,出现高热、呕吐和肌痛 1 天。初步实验室结果显示白细胞减少、天门冬氨酸转氨酶升高和丙氨酸转氨酶升高。胸部 X 线片未见肺部浸润。鼻咽拭子的逆转录酶-聚合酶链反应(RT-PCR)检测到 SARS-CoV-2,血液的 RT-PCR 检测到登革热病毒血清型 2。诊断为 COVID-19 与登革热合并感染。她的症状在支持性治疗下得到改善。临床表现、接触史、实验室特征和疾病进展的动态变化有助于医生进行准确诊断。登革热感染和 COVID-19 的共同循环和非特异性表现对热带国家的医疗保健系统构成挑战。为了解决这一威胁,需要多部门策略,包括公共卫生政策、开发准确的即时检测以及对这两种疾病的适当预防。