Dengue and Scrub Typhus Coinfection in a 17-Year-Old Male with Associated Meningoencephalitis: A Case Study

Dengue fever and scrub typhus are common causes of acute febrile illness especially in the post monsoon season. Due to many overlapping clinical features, scrub typhus infection may be missed in presence of dengue. Concurrent infection with those two pathogens is very rare and articles on dengue and scrub typhus coinfection are distinctly limited. In this study, we discuss a rare medical case of dengue fever and scrub typhus co-infection of a 17-year-old male admitted to RG Kar Medical college and hospital for treatment. Distinctive clinical features of the patient included thrombocytopenia, low albumin, significantly increased levels of Aspartate Transaminase and Alanine Transaminase, altered sensorium, increased intracranial pressure and acute meningoencephalitis. Timely diagnosis of the patient followed by treatment with the antibiotics, vancomycin, ceftriaxone, doxycycline, antiviral acyclovir and intravenous fluids resulted in complete recovery from both the diseases. The present case illustrates the clinical importance of early recognition of coinfection in unremitting febrile illness to prevent their fatal complications. High degree of suspicion has to be made for coinfection in a patient presenting with febrile illness with thrombocytopenia and deranged laboratory parameters in post monsoon season in endemic regions in Asia. In case of coinfection with dengue and scrub typhus, vigilant monitoring of vitals, platelets transfusion, and timely treatment are necessary.