Open AccessA coinfection of severe leptospirosis and scrub typhus in Indian Himalayas
Author(s) -
Vibha Mehta,
Ankith Bhasi,
Prasan Kumar Panda,
Pratima Gupta
Publication year - 2019
Publication title -
journal of family medicine and primary care
Language(s) - English
Resource type - Journals
eISSN - 2278-7135
pISSN - 2249-4863
DOI - 10.4103/jfmpc.jfmpc_614_19
Subject(s) - medicine , coinfection , leptospirosis , scrub typhus , myalgia , leptospira , hantavirus infection , jaundice , oliguria , zoonosis , orientia tsutsugamushi , serology , leukocytosis , immunology , virology , renal function , antibody , hantavirus , virus
Scrub typhus and leptospirosis are zoonosis and systemic febrile illnesses with diverse, nonspecific clinical manifestations, and shared risk factors for coinfection. Diagnosis of the coinfection is dependent on laboratory serological tests, which are under used. A coinfection from Uttarakhand Himalayan region is not yet reported. A 25-year-old man from altitude of 2126 feet above sea level presented with fever, myalgia, jaundice, oliguria, mental confusion, and tender hepatomegaly. Investigations revealed leukocytosis, thrombocytopenia, impaired liver function tests, renal dysfunction with neurological involvement. Leptospira immunoglobulin IgM enzyme linked immunosorbent assay (ELISA) and scrub typhus immunochromatography test were positive. This coinfection is first to be documented in this holy Indian Himalayas. Clinical suspicion, early laboratory diagnosis, and early treatment could prevent complications and fatal outcomes. Coinfection of this type may be considered when there is persistence of fever and a treatment response to doxycycline.