Dengue and typhoid co-infection: a case series from a tertiary care hospital in rural South India

Mahendraswamy B. H.; Pratheeksha  Harindran; Ananya  Vishvas; Sharadadevi Mannur Y.

doi:10.18203/2320-6012.ijrms20262655

Authors

Mahendraswamy B. H. Department of Microbiology, CDSIMER, Dayananda Sagar University, Bengaluru, Karnataka, India
Pratheeksha Harindran CDSIMER, Dayananda Sagar University, Bengaluru, Karnataka, India
Ananya Vishvas CDSIMER, Dayananda Sagar University, Bengaluru, Karnataka, India
Sharadadevi Mannur Y. Department of Microbiology, CDSIMER, Dayananda Sagar University, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20262655

Keywords:

Dengue, Typhoid, Widal test, Co-infection, Acute febrile illness

Abstract

Dengue and typhoid are important febrile illnesses endemic to India. A significant increase in incidence of these infections is observed during the monsoon season due to the vector borne and water borne origin respectively. When fever persists/symptoms are overlapping, co-infections with these two diseases should be suspected. Such co-infective conditions present with a clinical dilemma to diagnose and to provide optimum care and treatment. To avoid such dilemma, diagnosis should be made by considering clinical details, lab reports and radiological reports where applicable, keeping seasonality and endemicity in mind. In this case series, we present 4 cases of dengue and typhoid co-infection with an intent to create awareness regarding the early diagnosis and prompt treatment to improve patient condition and prevent mortality and morbidity. Diagnosis of dengue is made by taking relevant clinical details and NS1 antigen/IgM antibody positive status into consideration. Diagnosis of typhoid is made by considering relevant clinical details, widal test positive status with titer >1:80 for TO and TH.

References

Vigna SRV, Gopalsamy S, Srikanth P. Dengue and typhoid co-infection: A case report from a tertiary care hospital in South India. Int J Case Rep Images. 2016;7(9):563-5.

Muthuveeran S, Sathishkumar YG. Dengue and typhoid co-infection: a case report from a tertiary care hospital in Puducherry. Int J Contemp Pediatr. 2023;10:750-2.

Anjana A, Adhikary R, Bhavana MV. Burden of Dengue–Typhoid Coinfection in Pediatric Patients: A 6-year Experience from a Tertiary Care Center. Pediatr Inf Dis. 2023;5(2):42-4.

Mahato AK, Shrestha N, Gharti SB, Shah M. Typhoid Fever among Patients Diagnosed with Dengue in a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2022;60(252):714-7.

Division of Communicable Diseases. Syndromic surveillance of infectious diseases, priority pathogens to be tested for in Indian clinical settings. ICMR. Available at: https://www.icmr.gov.in/icmrobject/uploads/Static/1762753179_syndromesurveillanceofinfectiousdiseases.pdf. Accessed on 15 March 2026.

Vimal S, Vishwanathan V, Dharwadker A. Dengue and typhoid co-infection study. J Med Pharm Allied Sci. 2022;11(I2):4542-6.

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. J Clin Diagn Res. 2014;8(12):DC09-11.

Pegues DA, Miller SI. Salmonellosis. In: Kasper DL, Fauci AS, editors. Harrison’s Infectious Diseases. Chapter 54. 3rd ed. New York: McGraw-Hill Education; 2016.

Roy S, Ahmed F, Hasan R, Rahman M, Islam M. Blood culture and Widal test as diagnostic tools for enteric fever with antibiogram in a tertiary care centre at Dhaka in Bangladesh. Asian J Med Health. 2021;19(9):97-106.

Sarma A, Barkataki D. Comparative Study of Blood Culture with Rapid Diagnostic Tests for Diagnosis of Enteric Fever In A Tertiary Centre Of NE-India. J Med Sci. 2019;22(3):21-6.

Anithra CA, Anitha K, Prabhusaran N, Chitra Rajalakshmi P. Determination of baseline Widal titre among apparently healthy individuals of South India. Int J Pharm Clin Res. 2024;16(2):271-5.

Shethwala N, Shah A, Khatri H. Determination of baseline “Widal titre” amongst apparently healthy individuals at tertiary health care center. Indian J Microbiol Res. 2019;6(3):190-3.

Walke H, Palekar S. Endemic titer of Widal test in Kolhapur, India. Int J Curr Microbiol Appl Sci. 2014;3(11).

Ahmed GM, Kakkeri SR, Raysa NP, Usman SM. A study to determine significant titre-values of Widal test in the diagnosis of enteric fever for a population of north Kerala, India. Al Ameen J Med Sci. 2014;7(1):72-7.