Neurological manifestations like encephalitis, especially hemorrhagic encephalitis, are rarely described in dengue fever (DF), and the gamut may affect any part of the central or peripheral nervous system. Herein, we report two cases from Northern India, presenting with fever and altered sensorium, subsequently diagnosed with DF. Imaging studies revealed hemorrhagic encephalitis in both of them but one of them had a grave outcome, unfolding the fatal nature of the disease. The report enlightens DF as an unusual etiology of encephalitis and the importance of considering the infirmity as a differential in patients with neurological manifestations.

Patients with snakebites have highly variable presentations, and delayed diagnosis may lead to unfavorable outcomes. Here, we describe the case of a snakebite in a 23-year-old male who presented with myokymias. On management with mechanical ventilation and anti-snake venom, the patient improved and was discharged. The presence of myokymias may be an early clue to diagnosis and the need for mechanical ventilation in a patient with a snakebite.

Scrub typhus is a bacterial disease, caused by Orientia tsutsugamushi and has widespread clinical presentations. Coronavirus-19 disease (COVID-19) is an ongoing pandemic, which can demonstrate clinical symptoms similar to the scrub typhus. Herein, we are describing two such cases of scrub typhus and COVID-19 co-infection. A 35-year-old male and a 42-year-old female presented with respiratory failure, for which COVID-19 was diagnosed, but both of them had persistent thrombocytopenia. The patients were investigated for other tropical co-infections and the diagnosis of scrub typhus was established in both of the cases. Doxycycline was added to their ongoing treatment, which led to an uneventful recovery. The cases highlight the importance of keeping a high index of suspicion of concurrent infection in the regions where seasonal tropical infections are endemic.

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