Dengue and Typhoid Fever Coinfection in A Child

Abstract

The clinical features of commonly seen illnesses, such as malaria, enteric fever, dengue, chikungunya, scrub typhus, and leptospirosis mimic each other. Sometimes, concurrent infections within a patient make both diagnosis and subsequent management challenging. Concurrent infections can result in the overlapping of clinical features, posing a diagnostic dilemma for the treating clinician. Given that both typhoid fever and dengue fever are endemic in India, it is possible to be simultaneously infected by both the diseases. Herein we report the case of a 3-year-old child who presented with dengue and typhoid fever coinfection and subsequently recovered.

Dengue Typhoid Co-infection: a New Threat

“…In Bangladesh, dengue virus causes epidemic and sporadic cases year-round, with a peak from May to November, during the monsoon season. 2 Typhoid fever usually presents with progressive prolonged high fever without returning to normal. 2 The fever rises in increments like step leader and usually reaches 40-40.5°C by the end of the first week of illness.…”

“…Acute febrile illness is the most common clinical presentation among patients attending to doctor in developing countries. 1,2 In our Bangladesh most common cause of acute febrile illness in urban area are Dengue, Typhoid fever and Viral Hepatitis. In Bangladesh, dengue and typhoid fever have emerged as major public health problems.…”

“…3 But Co-infection of Dengue and Typhoid fever is rarely reported and are known to present with overlapping symptoms making the clinical diagnosis difficult. 1,2,3 The exact incidence of dengue and typhoid coinfection is not known. Dual infections tend to have prolonged fever, increased risk of complications and delayed in diagnosis.4 Here we report a case of coinfection of dengue with typhoid fever.…”

Dengue coinfection in a case of enteric fever: a diagnostic and therapeutic dilemma

“…Jagadishkumar et al diagnosed dengue by detecting IgM antibody and typhoid fever by positive blood culture in a 3-year-old child. 1 Vigna et al presented 2 cases of coinfection, 1 diagnosed by serological tests only, and the other by positive NS1 antigen and RT-PCR for dengue and growth of S. typhi in blood culture for typhoid fever. 2 Bansal et al managed 2 cases of dengue-enteric fever coinfection successfully as outpatients.…”

“…Actually, a few cases of such dengue-enteric fever coinfection have been reported so far, mostly from India. [1][2][3][4][5] Given that both dengue and enteric fever are endemic in Bangladesh, coinfection involving them is likely here as well, though to the best of our knowledge, none have yet been reported. On the other hand, high degree of suspicion is needed to think of the probability of dengue-enteric fever coinfection in individual patient, though uncommon, otherwise grave consequences may result.…”