Leptospira and Scrub typhus co-infection: An unusual presentation with delirium
Abstract
Leptospirosis and scrub typhus are zoonotic diseases with worldwide distribution. The spectra of clinical severity are wide for both diseases, ranging from mild to fatal. A diagnosis of coinfection with leptospirosis and scrub typhus can be difficult to make if the exposure history is overlooked but patients can die if not treated early. Here this case is with unusual presentation with coinfection of Leptospira and Scrub typhus, which was successfully treated.
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Introduction
Leptospira and Scrub typhus both are zoonotic diseases. Scrub typhus is a rickettsiosis caused by Orientiatsutsugamushi. It is transmitted by a chigger bite.1 Leptospirosis is also a zoonosis with global distribution. It is caused by infection with pathogenic spirochetes of the genus Leptospira. Human infection follows from exposure to infected animals, either directly or indirectly through contaminated soil and water,2 hile leptospira has a worldwide occurrence; Scrub typhus is limited to Asia-pacific region. Both the diseases are associated with farming and rainfall. Both these infectious diseases have a wide spectrum of clinical presentation from asymptomatic to potentially fatal disease. The co-infection with Leptospira and Scrub typhus can easily be overlooked and failure to diagnose the co-infection may lead to adverse outcome.
As this is a rare case of co-infection of Leptospira and Scrub typhus, so the case was thoroughly evaluated and a case report was prepared to publish.
Conclusion
This was concluded from this study that whenever presents with complaint of fever with altered sensorium, Leptospiriasis and Scrub typhus should also be included in differential diagnosis. Such patients should also investigate in line of Leptospiriasis and Scrub typhus. There may be co infection of both. When there is altered sensorium psychiatrist reference is must to prevent cognitive dysfunction as a sequel of this fatal co-infection. So cases with fever and altered sensorium may be treated accordingly, otherwise they may remain undiagnosed and may be fatal.