Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas
Abstract
:1. Introduction
2. Case Presentation
3. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | Laboratory Reference Range, Adults | On ED Admission | 9 h after ICU Admission | 12 h after ICU Admission |
---|---|---|---|---|
Hematocrit (%) | 35–50 | 39.8 | - | - |
Hemoglobin (g/dL) | 11.0–16.5 | 13.1 | - | - |
White blood cell count (per mm3) | 5.0–10 | 3.7 | - | - |
Differential count (%) | ||||
Granulocytes | 43–76 | 71.2 | - | - |
Lymphocytes | 17–48 | 25.2 | - | - |
Monocytes | 4.0–10 | 3.6 | - | - |
Platelet count (per mm3) | 150,000–450,0000 | 68,000 | - | - |
Erythrocyte count (per mm3) | 3,800,000–5,800,000 | 4,840,000 | - | - |
Erythrocyte sedimentation rate (mm/h) | 0–20 | 1 | - | - |
Total bilirubin (mg/dL) | 0–1.1 | 10.5 | - | - |
Indirect bilirubin (mg/dL) | 0–0.75 | 3.48 | - | - |
Direct bilirubin (mg/dL) | 0–0.25 | 7.02 | - | - |
Urea nitrogen (mg/dL) | 4.7–23 | 29 | - | - |
Creatinine (mg/dL) | 0.9–1.3 | 1.11 | - | - |
Blood venous gases | ||||
Inspired fraction of oxygen | - | - | 0.21 | 0.81 |
pH | 7.3–7.4 | - | 7.41 | 6.96 |
Partial pressure of carbon dioxide (mm/hg) | 38–50 | - | 21.5 | 38 |
Serum lactate (mg/dL) | - | - | 4.3 | 14 |
Partial pressure of oxygen (mm/hg) | 35–50 | - | 74 | 57 |
Serum glucose (mg/dL) | 70–99 | 145 | 47 | 43 |
Agent and Test | Result |
---|---|
Dengue IgM-antibodies | Positive |
NS1 protein ELISA for dengue | Positive |
Microagglutination test (MAT) for Leptospira interrogans | Positive |
Titers for serogroup Tarassovi, serovar Tarassovi | 1:400 |
Chikungunya RT-PCR | Positive |
Zika RT-PCR | Negative |
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Cardona-Ospina, J.A.; Jiménez-Canizales, C.E.; Vásquez-Serna, H.; Garzón-Ramírez, J.A.; Alarcón-Robayo, J.F.; Cerón-Pineda, J.A.; Rodríguez-Morales, A.J. Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas. Trop. Med. Infect. Dis. 2018, 3, 123. https://doi.org/10.3390/tropicalmed3040123
Cardona-Ospina JA, Jiménez-Canizales CE, Vásquez-Serna H, Garzón-Ramírez JA, Alarcón-Robayo JF, Cerón-Pineda JA, Rodríguez-Morales AJ. Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas. Tropical Medicine and Infectious Disease. 2018; 3(4):123. https://doi.org/10.3390/tropicalmed3040123
Chicago/Turabian StyleCardona-Ospina, Jaime A., Carlos E. Jiménez-Canizales, Heriberto Vásquez-Serna, Jesús Alberto Garzón-Ramírez, José Fair Alarcón-Robayo, Juan Alexander Cerón-Pineda, and Alfonso J. Rodríguez-Morales. 2018. "Fatal Dengue, Chikungunya and Leptospirosis: The Importance of Assessing Co-infections in Febrile Patients in Tropical Areas" Tropical Medicine and Infectious Disease 3, no. 4: 123. https://doi.org/10.3390/tropicalmed3040123