Clinical predictors of dengue fever co-infected with leptospirosis among patients admitted for dengue fever - a pilot study.

Published on Jun 28, 2017in Journal of Biomedical Science5.762
· DOI :10.1186/S12929-017-0344-X
Jeyanthi Suppiah5
Estimated H-index: 5
(UPM: Universiti Putra Malaysia),
Shie-Yien Chan1
Estimated H-index: 1
(UPM: Universiti Putra Malaysia)
+ 5 AuthorsHui-Yee Chee10
Estimated H-index: 10
(UPM: Universiti Putra Malaysia)
Background Dengue and leptospirosis infections are currently two major endemics in Malaysia. Owing to the overlapping clinical symptoms between both the diseases, frequent misdiagnosis and confusion of treatment occurs. As a solution, the present work initiated a pilot study to investigate the incidence related to co-infection of leptospirosis among dengue patients. This enables the identification of more parameters to predict the occurrence of co-infection.
Figures & Tables
📖 Papers frequently viewed together
1 Citations
13 Citations
63 Citations
: Leptospirosis is endemic in Southeast Asia, Central and South America, the Caribbean, and Oceania. Malaysia was categorized as a probable endemic country without any available data. Thus, this study was conducted to determine incidence, case fatality rate and mortality rate of leptospirosis. Leptospirosis is a notifiable disease in Malaysia since 2010 whereby probable or confirmed cases must be notified to relevant health district office. There were 3,665 and 4,457 probable and laboratory conf...
13 Citations
#1Kaushik Pan (Bangur Institute of Neurosciences)H-Index: 1
#2Ujjawal Roy (Bangur Institute of Neurosciences)H-Index: 5
Last. Ajay Panwar (King George's Medical University)H-Index: 5
view all 4 authors...
Leptospirosis is a zoonosis having a worldwide prevalence and has recently emerged as a major public health problem, especially in tropical and subtropical regions. Likewise, dengue is one of the major endemic health problems in the Indian subcontinent. It is a mosquito-borne arboviral infection causing considerable morbidity and mortality. Epidemiologically, mixed infections of dengue and leptospirosis are possible because similar environmental conditions are needed for the transmission of both...
3 CitationsSource
#1Douadi Benacer (UM: University of Malaya)H-Index: 6
#2Kwai Lin Thong (UM: University of Malaya)H-Index: 36
Last. Siti Nursheena Mohd Zain (UM: University of Malaya)H-Index: 11
view all 8 authors...
Abstract Leptospirosis is an emerging disease, especially in countries with a tropical climate such as Malaysia. A dramatic increase in the number of cases has been reported over the last decade; however, information on the epidemiological trends of this disease is lacking. The objective of this study is to provide an epidemiological description of human leptospirosis cases over a 9-year period (2004–2012) and disease relationship with meteorological, geographical, and demographical information....
25 CitationsSource
#1Laiane Fernanda de Melo Bezerra (UFC: Federal University of Ceará)H-Index: 2
#2Raissa Matos Fontes (UFC: Federal University of Ceará)H-Index: 3
Last. Danielle Malta Lima (UFC: Federal University of Ceará)H-Index: 13
view all 6 authors...
® ). Results: Of the 86 patients, 48 (55.8%) had positive results for dengue in at least one of the tests and five (7.35%) showed positive reactions for leptospirosis. Conclusion: During dengue epidemics, this disease may be misdiagnosed as other infections, including leptospirosis, when diagnosis is based on nonspecific clinical and laboratory criteria alone.
4 CitationsSource
Background Leptospirosis and dengue are endemic in countries with subtropical or tropical climates and have epidemic potential. The incidence of both these diseases peaks during monsoons and both diseases present with similar clinical manifestations making differentiation of leptospirosis from dengue difficult. It is important to distinguish leptospirosis from dengue as early antibiotic therapy in leptospirosis leads to a favourable outcome, while dengue has no specific treatment, yet early reco...
13 CitationsSource
Characterization of 14,079 circulating dengue viruses in a cross-border surveillance program, UNITEDengue, revealed that the 2013 outbreaks in Singapore and Malaysia were associated with replacement of predominant serotype. While the predominant virus in Singapore switched from DENV2 to DENV1, DENV2 became predominant in neighboring Malaysia. Dominance of DENV2 was most evident on the southern states where higher fatality rates were observed.
47 CitationsSource
The trend of dengue incidence in the regions and many countries has shown an increasing trend for the past few decades. The World Health Organization (WHO) reported that the incidence increased dramatically over the last 50 years and that dengue virus infections expanded to new countries, and from urban to rural settings. Malaysia is one of the countries that experience similar situation. The trend of dengue incidence in Malaysia has continued to increase since 2001 until 2014. In 2001, the deng...
40 CitationsSource
#1Sarah J. Wynwood (University of the Sunshine Coast)H-Index: 5
#2Mary-Anne Burns (Queensland Health)H-Index: 5
Last. Scott B. Craig (University of the Sunshine Coast)H-Index: 18
view all 6 authors...
A microsphere immunoassay (MIA) utilising Luminex xMap technology that is capable of determining leptospirosis IgG and IgM independently was developed. The MIA was validated using 200 human samples submitted for routine leptospirosis serology testing. The traditional microscopic agglutination (MAT) method (now 100 years old) suffers from a significant range of technical problems including a dependence on antisera which is difficult to source and produce, false positive reactions due to auto-aggl...
12 CitationsSource
#1RK SinghH-Index: 1
#1RK Singh (SGPGIMS: Sanjay Gandhi Post Graduate Institute of Medical Sciences)H-Index: 4
Last. Arvind K Baronia (SGPGIMS: Sanjay Gandhi Post Graduate Institute of Medical Sciences)H-Index: 14
view all 4 authors...
Co-infection in immunocompetent patients is rare. Though co-infection with dengue and leptospira cases is increasingly reported, a co-infection of this combination along with hepatitis E is rarely thought of. Until date only two case of triple co-infection have been reported world-wide. Here, we are reporting a patient with co-infection of dengue, leptospirosis and hepatitis E admitted to our intensive care unit. Early septic shock and increasing procalcitonin in dengue patient raised suspicion ...
3 CitationsSource
#1Boon-Teong Teoh (UM: University of Malaya)H-Index: 16
#2Sing-Sin Sam (UM: University of Malaya)H-Index: 15
Last. Sazaly AbuBakar (UM: University of Malaya)H-Index: 49
view all 10 authors...
Background Recurring dengue outbreaks occur in cyclical pattern in most endemic countries. The recurrences of dengue virus (DENV) infection predispose the population to increased risk of contracting the severe forms of dengue. Understanding the DENV evolutionary mechanism underlying the recurring dengue outbreaks has important implications for epidemic prediction and disease control.
40 CitationsSource
Cited By9
#1Begam Nn (AIIMS: All India Institute of Medical Sciences)
#1Nazneen Nahar Begam (AIIMS: All India Institute of Medical Sciences)
Last. Ashutosh Biswas (AIIMS: All India Institute of Medical Sciences)H-Index: 15
view all 10 authors...
Dengue is a life-threatening mosquito borne viral disease. We are still in the era of supportive treatment where morbidity and mortality are a major concern. Dengue infection in presence of other co-infections makes this scenario rather worse. Timely recognition and raising alarm to be intensive is the need of the hour for primary care physicians practicing in the community and indoors. This review provides a comprehensive knowledge about the recent trends of coinfection in dengue as well as the...
#1Juana del Valle-Mendoza (UPC: Universidad Peruana de Ciencias Aplicadas)H-Index: 10
#2Carlos Palomares-Reyes (UPC: Universidad Peruana de Ciencias Aplicadas)H-Index: 5
Last. Wilmer Silva-Caso (UPC: Universidad Peruana de Ciencias Aplicadas)H-Index: 9
view all 12 authors...
OBJECTIVE This study was carried out to determine the prevalence of leptospirosis among febrile patients with a suspicious clinical diagnosis of dengue fever in northern Peru. RESULTS A total of 276 serum samples from patients with acute febrile illness (AFI) and suspected diagnosis for dengue virus (DENV) were analyzed. We identified an etiological agent in 121 (47.5%) patients, DENV was detected in 30.4% of the cases, leptospirosis in 11.2% and co-infection by both pathogens was observed in 5....
#1Noraini Philip (UPM: Universiti Putra Malaysia)H-Index: 4
#2Norliza Bahtiar Affendy (UPM: Universiti Putra Malaysia)H-Index: 1
Last. Vasantha Kumari Neela (UPM: Universiti Putra Malaysia)H-Index: 17
view all 16 authors...
Background Leptospirosis, commonly known as rat-urine disease, is a global but endemic zoonotic disease in the tropics. Despite the historical report of leptospirosis in Malaysia, the information on human-infecting species is limited. Determining the circulating species is important to understand its epidemiology, thereby to strategize appropriate control measures through public health interventions, diagnostics, therapeutics and vaccine development. Methodology/Principle findings We investigate...
6 CitationsSource
#1Paul Le TurnierH-Index: 2
#1Paul Le TurnierH-Index: 7
Last. Loïc EpelboinH-Index: 16
view all 10 authors...
Objective: Leptospirosis and dengue fever (DF) are hard-to-differentiate diseases in cocirculating areas, especially during DF epidemics. Misdiagnosis and ensuing lack of antibiotic therapy can be detrimental in leptospirosis. The objective of this study was to identify factors that help differentiate acute leptospirosis from dengue fever on admission. Method: Patients with leptospirosis (positive serology or polymerase chain reaction) were compared with patients with DF (positive nonstructural ...
1 CitationsSource
#2A. S. V. MendisH-Index: 1
Last. Suneth Agampodi (Rajarata University of Sri Lanka)H-Index: 18
view all 6 authors...
Background Severe leptospirosis is known to cause multi organ dysfunction including cardiac involvement. In the clinical setting with limited resources, high degree of suspicion is needed to diagnose cardiac involvement including myocarditis. Although myocarditis is not reported as a common complication due to lack of diagnostic facilities, there are evidence to support myocarditis is more prevalent in post mortem studies of patients died due to leptospirosis. We present a case series of severe ...
4 CitationsSource
The febrile patient from tropical areas, in which emerging arboviruses are endemic, represents a diagnostic challenge, and potential co-infections with other pathogens (i.e., bacteria or parasites) are usually overlooked. We present a case of an elderly woman diagnosed with dengue, chikungunya and Leptospira interrogans co-infection. Study Design: Case report. An 87-year old woman from Colombia complained of upper abdominal pain, arthralgia, myalgia, hyporexia, malaise and intermittent fever acc...
4 CitationsSource
#1Arun Sachu (T. D. Medical College)H-Index: 1
#1Arun SachuH-Index: 3
view all 4 authors...
Background and Objectives: Dengue and Leptospirosis were often discussed separately with rash being more common in dengue and jaundice in leptospirosis. But with increasing reports of co-infection, the situation has become worse. The main objective of this study was to look for the presence of both Dengue and Leptospira IgM antibodies in serum samples of patients, presenting with acute febrile illness. Medical records of the co-infected patients were examined to analyse the clinical features and...
5 Citations
#1Munirah HishamshahH-Index: 1
#2Norazah AhmadH-Index: 12
Last. Fairuz AmranH-Index: 7
view all 6 authors...
Purpose. In this study, we aim to describe and compare the demographical, clinical and laboratory features of leptospirosis and dengue co-infections (LDCI) against single leptospirosis infections in Malaysia. Methodology. Data of patients admitted to various hospitals in Malaysia from 2011 to 2015 diagnosed with leptospirosis in our laboratory were obtained from their admission records. Co-infection with dengue was determined by collecting dengue serology results. Multivariate analysis and multi...
4 CitationsSource
#1Sophia G. de Vries (UvA: University of Amsterdam)H-Index: 6
#2Benjamin J Visser (UvA: University of Amsterdam)H-Index: 14
Last. Martin P. Grobusch (University of Tübingen)H-Index: 68
view all 17 authors...
Leptospirosis is a potentially fatal emerging zoonosis with worldwide distribution and a broad range of clinical presentations and exposure risks. It typically affects vulnerable populations in (sub)tropical countries but is increasingly reported in travelers as well. Diagnostic methods are cumbersome and require further improvement. Here, we describe leptospirosis among travelers presenting to the GeoSentinel Global Surveillance Network. We performed a descriptive analysis of leptospirosis case...
6 CitationsSource
#2Robyn A. Stoddard (CDC: Centers for Disease Control and Prevention)H-Index: 19
Last. Elsio A. Wunder (FIOCRUZ: Oswaldo Cruz Foundation)H-Index: 22
view all 12 authors...
National Institutes of Health [R01 TW009504, R25 TW009338, U01 AI088752, R01 AI052473 and D43 TW00919; Coordination for the Improvement of Higher Education Personnel (CAPES) from the Brazilian Ministry of Education; National Council of Scientific and Technological Development (CNPq)
23 CitationsSource