Co-infection of scrub typhus and leptospirosis in patients with pyrexia of unknown origin in Longding district of Arunachal Pradesh in 2013

Borkakoty, Biswajyoti; Jakharia, Aniruddha; Biswas, Dipankar; Mahanta, Jagadish

doi:10.4103/0255-0857.174116

Cited by 30 publications

(27 citation statements)

References 5 publications

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“…Although awareness of Plasmodium /DENV co-infections is increasing, little information is available about Plasmodium / Leptospira or Plasmodium / O. tsutsugamushi co-infections ( 13 , 29 ). This lack of information is concerning because our study suggests that Plasmodium / Leptospira co-infections are associated with severe malaria.…”

Section: Discussionmentioning

confidence: 99%

“…Prevalence data for co-infections with these pathogens are limited. We emphasize the need for such information because although these pathogens are carried by different vectors, they co-exist in the same geoclimactic habitats that combine a warm, moist environment with dense vegetation and poor socio-economic development ( 13 , 29 ). The presence of one co-infecting pathogen can influence disease outcomes, treatment outcomes, development of immunity, or drug resistance with regard to infections caused by the other co-infecting pathogen.…”

Section: Discussionmentioning

confidence: 99%

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Association of Dengue Virus and Leptospira Co-Infections with Malaria Severity

Mandage¹,

Kaur²,

Pramanik³

et al. 2020

Emerg. Infect. Dis.

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I n tropical countries, including India, acute febrile illnesses (AFIs) constitute a group of infections with similar manifestations, such as fever, malaise, body aches, chills, hepatic and renal dysfunction, and central nervous system effects. The causative agents of AFI can be bacterial (e.g., Orientia tsutsugamushi, Leptospira, and Salmonella enterica serovar Typhi), parasitic (protozoans of the apicomplexa family), or viral (e.g., dengue virus [DENV], chikungunya virus [CHIKV], influenza A[H1N1] virus) (1-4). Distinguishing between the causative agents of AFIs can be difficult. In tropical climates, several AFI pathogens,

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of Dengue Virus and Leptospira Co-Infections with Malaria Severity

Mandage¹,

Kaur²,

Pramanik³

et al. 2020

Emerg. Infect. Dis.

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“…Behavioral risk factors such as outdoor activity or sleeping, lack of personal protective measures and conducive environment for the vector, are common for the vector borne co-endemic diseases like scrub typhus, malaria, leptospirosis and dengue in India. Therefore, co-infections are not uncommon [ 47 – 52 ]. Early identification of such co infections is crucial as their treatments differ drastically and also to avert the complications and mortality.…”

Section: Discussionmentioning

confidence: 99%

Clinical and paraclinical profile, and predictors of outcome in 90 cases of scrub typhus, Meghalaya, India

et al. 2016

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BackgroundIndia is an integral component of “tsutsugamushi triangle” which depicts a part of the globe endemic to scrub typhus. Owing to frequent outbreaks witnessed in different parts of the country in the recent past, scrub typhus is described as a re-emerging infectious disease in India. The present study aimed to study the clinical and paraclinical profile, complications and predictors of outcome among 90 cases of scrub typhus diagnosed in a hospital of north-eastern India from Sept 2011 to Aug 2012.MethodsA longitudinal study was conducted in a hospital of Meghalaya, India between Sept 2011 and Aug 2012. Diagnosis of scrub typhus was arrived by SD BIOLINE tsutsugamushi (solid phase immunochromatographic assay) rapid diagnostic test for antibodies (IgM, IgG or IgA). Descriptive analyses of age, gender, geographic area, symptoms and signs, treatment, laboratory findings, complications, and outcome were conducted. Relative risk (RR) with 95 % confidence interval (CI) was computed for Multiple Organ Dysfunction Syndrome (MODS) and mortality. Binary logistic regression was applied to the significant correlates (P < 0.05) on univariate analysis to identify the predictors of MODS and mortality in scrub typhus.ResultsAs many as 662 clinically suspected scrub typhus patients were tested and 90 (13.6 %) were diagnosed to have scrub typhus. Out of 90 patients, 52.2 % (n = 47) were males and their mean (SD) age was 36.29 (13.38) years. Fever of <7 days (n = 75, 83.3 %), myalgia (n = 56, 62.2 %), pain abdomen (n = 24, 26.7 %), headache (n = 24, 26.7 %), nausea/vomiting (n = 21, 23.3 %), dry cough (n = 21, 23.3 %), hepatomegaly (n = 24, 26.7 %), splenomegaly (n = 22, 24.4 %), and lymphadenopathy (n = 20, 22.2 %) were the predominant clinical features. Eschar was seen in 10 patients (11.1 %). One third (n = 30) of the patients developed at least one systemic complication. Acute hepatitis (n = 15, 16.7 %), pneumonitis (n = 14, 15.6 %), and acute kidney injury (n = 11, 12.2 %) were the common complications. MODS was seen in 14.4 % (n = 13) and 38.5 % (n = 5) of the patients with MODS died. Overall, case fatality rate was 5.15 % (n = 5). On univariate analysis, platelets <100 000/mm3, serum creatinine >1.5 mg/dl, and transaminase (AST, ALT or both) >500 U/L were associated with MODS (P < 0.001) and mortality (P < 0.05). In addition, serum bilirubin >3 mg/dl was also associated with MODS (P < 0.001). On applying binary logistic regression, serum creatinine >1.5 mg/dl was a predictor of MODS (OR: 76.1, 95 % CI: 4.9–1175.6) and mortality (OR: 18.03, 95 % CI: 1.38–235.1).ConclusionIn this study setting, approximately one-seventh (13.6 %) of the acute undifferentiated febrile illness were due to scrub typhus. Systemic complications were common (33.3 %). Serum creatinine >1.5 mg/dl was a predictor of MODS and mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0186-x) contains supplementary material, which is available to authorized users.

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“…tsutsugamushi for each country is shown in Table 1 [ 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 ]. The reports of outbreaks of scrub typhus are summarized in Table 2 [ 43 , 94 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 1...…”

Section: Methodsmentioning

confidence: 99%

A review of the global epidemiology of scrub typhus

et al. 2017

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Scrub typhus is a serious public health problem in the Asia-Pacific area. It threatens one billion people globally, and causes illness in one million people each year. Caused by Orientia tsutsugamushi, scrub typhus can result in severe multiorgan failure with a case fatality rate up to 70% without appropriate treatment. The antigenic heterogeneity of O. tsutsugamushi precludes generic immunity and allows reinfection. As a neglected disease, there is still a large gap in our knowledge of the disease, as evidenced by the sporadic epidemiologic data and other related public health information regarding scrub typhus in its endemic areas. Our objective is to provide a systematic analysis of current epidemiology, prevention and control of scrub typhus in its long-standing endemic areas and recently recognized foci of infection.

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Co-infection of scrub typhus and leptospirosis in patients with pyrexia of unknown origin in Longding district of Arunachal Pradesh in 2013

Abstract: The present study is the first report of co-infection of scrub typhus with leptospirosis from Northeast India. Medical officers in this region should take scrub typhus and leptospirosis in their differential diagnosis of patients with PUO for early diagnosis and effective treatment.

Cited by 30 publications

References 5 publications

Association of Dengue Virus and Leptospira Co-Infections with Malaria Severity

Association of Dengue Virus and Leptospira Co-Infections with Malaria Severity

Clinical and paraclinical profile, and predictors of outcome in 90 cases of scrub typhus, Meghalaya, India

A review of the global epidemiology of scrub typhus

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