Case series of fatal Leptospira spp./dengue virus co-infections-Puerto Rico, 2010-2012.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Pérez Rodríguez, NM; Galloway, R; Blau, DM; Traxler, R; Bhatnagar, J; Zaki, SR; Rivera, A; Torres, JV; Noyd, D; Santiago-Albizu, XE; Rivera García, B; Tomashek, KM; Bower, WA; Sharp, TM

Published Date

  • October 2014

Published In

Volume / Issue

  • 91 / 4

Start / End Page

  • 760 - 765

PubMed ID

  • 25092820

Pubmed Central ID

  • PMC4183400

Electronic International Standard Serial Number (EISSN)

  • 1476-1645

Digital Object Identifier (DOI)

  • 10.4269/ajtmh.14-0220


  • eng

Conference Location

  • United States