Comparison between Three Rare Cases of Co‑Infection with Dengue, Leptospira and Hepatitis E: Is Early Endothelial Involvement the Culprit in Mortality?

Author(s):

Singh RK, Ghatak T, Saigal S, Baronia AK

CoâÂÃ?Â?ÂÃ?Â?infection in immunocompetent patients is rare. Though coâÂÃ?Â?ÂÃ?Â?infection with dengue and leptospira cases is increasingly reported, a coâÂÃ?Â?ÂÃ?Â?infection of this combination along with hepatitis E is rarely thought of. Until date only two case of triple coâÂÃ?Â?ÂÃ?Â?infection have been reported worldâÂÃ?Â?ÂÃ?Â?wide. Here, we are reporting a patient with coâÂÃ?Â?ÂÃ?Â?infection of dengue, leptospirosis and hepatitis E admitted to our intensive care unit. Early septic shock and increasing procalcitonin in dengue patient raised suspicion of coâÂÃ?Â?ÂÃ?Â?infection. Our aim is to educate intensivists about this rare coâÂÃ?Â?ÂÃ?Â?infection and hence that timely initiation of appropriate diagnostic, therapeutic and supportive measures can alter outcome favorably.