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Category: Volume 08 Issue 02 February 2020
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Title: Emerging Co-Infections in Dengue: A Hospital Based Study

Authors: Srikant Kumar Dhar, Uday Bhanu Rout, Suse Naqash Nadar, K Sruthi, Nalini Kanta Sahoo, Saptaswa Nayak

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.142

Abstract

   

Background: Concurrent infection with two agents can result in an illness having overlapping symptoms creating a diagnostic confusion for the treating physician. This study attempts to find the current co-infections rates in dengue patients in a tertiary care hospital Eastern Odisha.

Method: Study conducted from July 2018 to June 2019 comprising of 100 dengue seropositive (NS1/IgM/IgG) patients of age >15 years in IMS & SUM Hospital.

Result: In our study 57% were NS1 positive and 28% had IgM positive for Dengue. NS1 and IgM positive in 8% patients, IgM and IgG positive in 3 % of case which indicated secondary cases and 2 cases with all NS1, IgM,IgG for Dengue positive. Out of 100 dengue patients, 39 % patients had co-infections. In which 12% were ICT positive for malaria, 9% salmonella IgM reactive, 8% Scrub typhus IgM reactive, 8% chikungunya IgM reactive, 2% Hepatitis B positive. We have found 2% mixed co-infections in dengue IgM positive patients. In our series in clinical manifestations all case (100%) presented with fever, mylagia (70%), headache (52%), rashes (22%), vomiting (17%), retro orbital pain (12%), abdominal pain (10%), yellowish sclera (4%), oliguria (2%), alter sensorium (2%) and bleeding manifestations (46%) cases. Complications detected hepatopathy (52%), ascites (10%), pleural effusion (8%), pneumonia (7%), splenomegaly (7%) nephropathy (5%), DSS (4%), MODS (4%) and DHS in 20 % of cases.

Conclusion:  Co-infection should always be kept in mind while dealing with cases of dengue fever.This study brings out the incidence of dengue and co-infections and also differentiate concurrent infections.

Keywords: Coinfections, Dengue, malaria, salmonella, Scrub Typhus,  chikungunya.

References

  1. Martelli CMT, Siqueira JB, Parente MPPD, Zara ALde SA, Oliveira CS, Braga C, et al. Economic Impact of Dengue: Multicenter Study across Four Brazilian Regions .PLoS neglected tropical diseases. Public Library of Science; 2015.
  2. Gupta N, Srivastava S, Jain A, Chaturvedi UC. Dengue in India. The Indian journal of medical research. Medknow Publications & MediaPvt Ltd; 2012.
  3. Bavia L, Mosimann ALP, Aoki MN, Duarte Dos Santos CN. A glance at subgenomicflavivirus RNAs and microRNAs in flavivirus infections. Virology journal. BioMed Central; 2016 .
  4. Gupta P, Khare V, Tripathi S, Nag V, Kumar R, Khan M, et al. Assessment of World Health Organization definition of dengue hemorrhagic fever in North India. The Journal of Infection in Developing Countries. 2010;4(03):150-5.
  5. Srikant D, A Study on the Clinicopathological Profile and Outcome of a Dengue Epidemic in Western Odisha. Int J Med Science and Innovative Research. 2017;2(4):13- 20.
  6. Capeding MR, Chua MN, Hadinegoro SR, et al. Dengue and other common causes of acute febrile illness in Asia: an active surveillance study in children. PLoSNegl Trop Dis. 2013;7(7):e2331. 
  7. Chrispal A, Boorugu H, Gopinath K, et al. Acute undifferentiated febrile illness in adult hospitalized patients: the disease spectrum and diagnostic predictors – an experience from a tertiary care hospital in South India. Trop Doct. 2010;40(4):230–34.
  8. Wangdi K, Kasturiaratchi K, Nery SV, Lau CL, Gray DJ, Clements ACA. Diversity of infectious aetiologies of acute undifferentiated febrile illnesses in south and Southeast Asia: a systematic review . BMC infectious diseases. BioMed Central; 2019.
  9. Magalha ES. Clinical Profile of Concurrent Dengue Fever and Plasmodium   vivax Malaria in the Brazilian Amazon: Case Series of 11 Hospitalized Patients. Am J Trop Med Hyg2012; 87:1119–1124
  10. Sharma Y, Arya V, Jain S, Kumar M, Deka L, Mathur A. Dengue and Typhoid Co-infection- Study from a Government Hospital in North Delhi. Journal of clinical and diagnostic research : JCDR. JCDR Research and Publications (P) Limited; 2014.
  11. Abhilash KP, Mitra S, Gautam I, Jambugulam M, Jayaseeelan V. Clinical score to differentiate scrub typhus and dengue: A tool to differentiate scrub typhus and dengue. Journal of Global Infectious Diseases. 2017;9(1):12.
  12. Abhishek KS, Chakravarti A. Simultaneous detection of IgM antibodies against dengue and chikungunya: Coinfection or cross-reactivity? . Journal of family medicine and primary care. Wolters Kluwer - Medknow; 2019.
  13. Cunha BA, Gran A, Klein NC. Fever Differentiating between Dengue Fever and Chikungunya Fever. Infection & Chemotherapy. 2015;47(2):123.

Corresponding Author

Uday Bhanu Rout

Department of Medicine, IMS & SUM Hospital, Siksha “O” Anusandhan, K8, Kalinganagar Bhubaneswar, Odisha, India