Case series of fatal Leptospira spp./dengue virus co-infections-Puerto Rico, 2010-2012.
Co-infection with pathogens that cause acute febrile illness creates a diagnostic challenge as a result of overlapping clinical manifestations. Here, we describe four fatal cases of Leptospira species/dengue virus co-infection in Puerto Rico. Although all patients sought care early, antibiotic administration was delayed for most. Steroids were administered to all patients, in most cases before antibiotics. These cases show the need for clinicians evaluating patients in or recently returned from the tropics with acute febrile illness to consider both dengue and leptospirosis. Furthermore, they illustrate the need for nucleic acid- or antigen-based rapid diagnostic tests to enable timely patient diagnosis and management. In particular, antibiotic therapy should be initiated early for patients with suspected leptospirosis, and steroids should not be administered to patients with suspected dengue.
Duke Scholars
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- Young Adult
- Tropical Medicine
- Steroids
- Puerto Rico
- Middle Aged
- Male
- Leptospirosis
- Leptospira
- Humans
- Fatal Outcome
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Young Adult
- Tropical Medicine
- Steroids
- Puerto Rico
- Middle Aged
- Male
- Leptospirosis
- Leptospira
- Humans
- Fatal Outcome