DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20191646

Concurrent dengue and typhoid infection: study from a tertiary care centre in Muzaffarnagar, India

Sapna Chauhan, Sachin Sharma, Surender ., Paramjit Singh

Abstract


Background: Acute febrile illness is a common presenting complaint during the rainy season. Rains predispose to both water and vector borne diseases. Co-infection of dengue with malaria, leptospirosis, typhoid, scrub typhus and other arboviral diseases can occur in endemic areas. Such dual infections are difficult to diagnose and create a diagnostic dilemma for the treating physician. Here in this study authors attempt to find out rates of concurrent dengue and typhoid infection.

Methods: This retrospective study was done between August to November 2017. 403 patients presenting with acute febrile illness were studied. Diagnosis of dengue was done by rapid card test detecting NS1 antigen, IgM and IgG antibodies. Serodiagnosis of Salmonella infection was done by tube Widal test.

Results: : Out of 403 febrile sera samples tested 154 (38.2%) were positive for dengue (either NS1 antigen or IgM antibodies or both), 71(17.6%) were positive for Widal test O and H titres ≥1:160) and 28 (6.9%) were positive for both dengue as well as Salmonella (Widal test).

Conclusions: Acute febrile illnesses with diagnostic dilemma may be seen in cases of co-infection. Only better clinical judgement and right choice of laboratory tests can diagnose these diseases timely and prevent fatal outcomes.

Keywords


Concurrent infection, Dengue, Febrile, Typhoid

Full Text:

PDF

References


Ganeshkumar P, Murhekar MV, Poornima V, Saravanakumar V, Sukumaran K, Anandaselvasankar A, et al. Dengue infection in India: A systematic review and meta-analysis. PloS Neglect Tropical Dis. 2018;12(7):e0006618.

John J, Van Aart CJ, Grassly NC. The burden of typhoid and paratyphoid in India: systematic review and meta-analysis. PLoS Neglect Tropical Dis. 2016;10(4):e0004616.

Chrispal A, Boorugu H, Gopinath KG, Chandy S, Prakash JA, Thomas EM, 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. Tropical Doctor. 2010;40(4):230-4.

Rodrigues C. The widal test- more than 100 years old: abused but still used. J Assoc Physicians India. 2003;51:7-8.

Chauhan S, Sharma S. Study of baseline Widal titre amongst apparently healthy individuals in and around Muzaffarnagar city of Uttar Pradesh. Int J of Pharma Bio Sci. 2016;7(1):152-155.

Paniker CKJ, eds. Ananthanarayan and Paniker’s text book of microbiology. 7th ed. Chennai: Orient Longman Private Ltd; 2005.

Chheng K, Carter MJ, Emary K, Chanpheaktra N, Moore CE, Stoesser N, et al. A prospective study of the causes of febrile illness requiring hospitalization in children in Cambodia. PloS One. 2013;8(4):e60634.

Chheng K, Carter MJ, Emary K, Chanpheaktra N, Moore CE, Stoesser N, et al. A prospective study of the causes of febrile illness requiring hospitalization in children in Cambodia. PloS One. 2013;8(4):e60634.

Chahar HS, Bharaj P, Dar L, Guleria R, Kabra SK, Broor S. Co-infections with chikungunya virus and dengue virus in Delhi, India. Emerg Infect Dis. 2009;15(7):1077.

Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s principles and practice of Infectious Diseases. 7th ed. Philadelphia: Churchill Livingstone; 2010.

Dikid T, Jain SK, Sharma A, Kumar A, Narain JP. Emerging & re-emerging infections in India: An overview. Indian J Med Res. 2013;138(1):19.

Kasper MR, Blair PJ, Touch S, Sokhal B, Yasuda CY, Williams M, et al. Infectious etiologies of acute febrile illness among patients seeking health care in south-central Cambodia. Am J Tropical Med Hygiene. 2012;86(2):246-53.

Baba M, Logue CH, Oderinde B, Abdulmaleek H, Williams J, Lewis J, et al. Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria. J Infect Develop Count. 2013;7(01):051-9.

Ahmed F, Chowdhury K, Alam J, Arefeen S, Alam MM. Co-infection of typhoid fever with hepatitis A, hepatitis E and dengue fever: A challenge to the physicians. Am J Trop Med Hyg. 2012;86(2):246-53.

Sudjana P, Jusuf H. Concurrent dengue haemorrhagic fever and typhoid fever infection in adult: case report. Southeast Asian J Trop Med Pub Heal. 1998;29:370-2.

Kamath SR, Ranjit S. Clinical features, complications and atypical manifestations of children with severe forms of dengue haemorrhagic fever in South India. Indian J Pediat. 2006;73(10):889-95.

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 Clinic Diagnost Res. 2014;8(12):DC09.