Department of Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet, 3100, Bangladesh.
J Med Case Rep. 2024 Aug 7;18(1):370. doi: 10.1186/s13256-024-04675-0.
Both dengue and Leptospira infections are endemic to tropical and subtropical regions, with their prevalence increasing in recent decades. Coinfection with these pathogens presents significant diagnostic challenges for clinicians due to overlapping clinical manifestations and laboratory findings. This case report aims to elucidate two clinical scenarios where the coinfection of dengue and leptospirosis complicates the disease course, creating a diagnostic conundrum.
We present the clinical scenarios of two Bangladeshi males, aged 25 and 35 years, who were admitted to our hospital with acute febrile illness. The first patient exhibited hepatic and renal involvement, while the second presented with symptoms initially suggestive of meningoencephalitis. Both cases were initially managed under the presumption of dengue infection based on positive serology. However, further evaluation revealed coinfection with Leptospira, complicating the disease course. Both patients received appropriate treatment for dengue and antibacterial therapy for leptospirosis, ultimately resulting in their recovery.
These case scenarios underscore the critical importance for clinicians in regions where dengue and Leptospira are endemic to consider both diseases when evaluating patients presenting with acute febrile illness.
登革热和钩端螺旋体病均流行于热带和亚热带地区,近几十年来其发病率呈上升趋势。由于临床表现和实验室结果存在重叠,这两种病原体的合并感染给临床医生带来了重大的诊断挑战。本病例报告旨在阐明两种临床情况,即登革热和钩端螺旋体病的合并感染使疾病进程复杂化,从而造成诊断难题。
我们介绍了两名孟加拉国男性患者的临床情况,年龄分别为 25 岁和 35 岁,他们因急性发热性疾病入住我院。第一例患者表现为肝肾功能损害,而第二例患者最初表现为脑膜脑炎的症状。根据阳性血清学结果,这两例最初均被误诊为登革热感染,并进行了相应治疗。然而,进一步评估显示存在钩端螺旋体合并感染,使疾病进程复杂化。两名患者均接受了针对登革热的适当治疗和针对钩端螺旋体病的抗菌治疗,最终康复。
这些病例情况突显了对于流行登革热和钩端螺旋体病地区的临床医生的重要性,他们在评估急性发热性疾病患者时,必须考虑到这两种疾病。