Coinfection with dengue and hepatitis A complicated with infective endocarditis in a Yemeni patient: a case report

Abstract

Introduction Coinfection with dengue and hepatitis A is rare and challenging for physicians since their clinical features can be overlapping. These infections are self-limiting but can become complicated by subsequent infective endocarditis. We report a case of infective endocarditis following a coinfection with dengue and hepatitis A. Case presentation A 17-year-old Yemeni male patient was admitted to the hospital complaining of yellowish discoloration of the skin and sclera associated with dark urine and a diffuse skin rash on the trunk and upper limbs followed by intermittent high-grade fever. Coinfection was confirmed by hepatitis A immunoglobulin M and dengue immunoglobulin M. At the time of diagnosis, white blood cells were normal, with mild neutrophilia and thrombocytopenia along with elevated C-reactive protein. Five days later, the patient was readmitted to the emergency department, complaining of high-grade fever, fatigue, myalgia, nausea, and vomiting. A systolic heart murmur was heard, and infective endocarditis was confirmed by the visualization of two vegetations on the mitral valve and coagulase-negative staphylococci after blood culture. Supportive therapies were initiated for hepatitis A and dengue fever, whereas infective endocarditis was treated with antibiotics for 4 weeks. The patient recovered completely from dengue, hepatitis A, and infective endocarditis. Conclusion In endemic areas, it is reasonable to screen for coinfection with dengue and hepatitis A since they are superimposed on each other. Subacute infective endocarditis may occur following initial dengue and hepatitis A coinfection, especially among patients with rheumatic heart disease. An echocardiogram is a pivotal workup for evaluating a patient with persistent fever of unknown origin.

Co-Infection of Dengue and Hepatitis a Viruses: A Rare Case Report

“…In this case report, the patient presented symptoms of both dengue fever and acute liver inflammation, such as fever, headache, muscle and joint pain, rash, and jaundice. If an individual is infected with both viruses simultaneously, the symptoms of each virus may be more severe and have more complications ( Ranathunga et al, 2019;Alemad et al, 2021).…”

Coinfection of dengue and hepatitis A viruses: a rare case report

“…In this case report, the patient presented symptoms of both dengue fever and acute liver in ammation, such as fever, headache, muscle and joint pain, rash, and jaundice. If an individual is infected with both viruses simultaneously, the symptoms of each virus may be more severe and have more complications 7,8 .…”

Detection of hepatitis viruses in suspected cases of Viral Haemorrhagic Fevers in Nigeria

“…These feacal-orally transmitted hepatitis agents have major public health implications in sub-Saharan Africa as HEV outbreaks is reported nearly annually with some outbreaks involving more than 10,000 cases [ 12 , 16 , 26 ]. In Nigeria, there have been documented serologic evidence of previous exposure to HAV infection in most children by five years of age [ 5 , 12 , 27 , 28 ]. However, the actual burden and prevalences of both HAV and HEV are grossly underestimated in Africa due to some deficiencies in the surveillance and monitoring systems [ 29 ].…”