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

Abstract

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 of co‑infection. Our aim is to educate intensivists about this rare co‑infection and hence that timely initiation of appropriate diagnostic, therapeutic and supportive measures can alter outcome favorably.

Keywords: Co‑infection, Dengue, Endothelium, Hepatitis E, Leptospirosis