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Doctors shocked by coinfection of diseases – in a single patient

At the Sawai Man Singh Hospital in Jaipur an uncommon situation arose. One patient was coinfected with several infectious diseases. Such a situation is rare, but exposes a potential hazard in rapid diagnosis of a single condition.

Such a situation is rare. While many infectious diseases are common in India, it is fairly unusual for a person to be infected with a number of diseases at once. The case in Jaipur – of 63-year old Kiran – exposes the potential hazards of rapidly diagnosing a single condition.

Copyright: p6m5 / 123RF Stock PhotoKiran was taken to hospital suffering from pneumonia, breathing problems, low platelet count and abnormal liver and kidney function. Medical analysis at the hospital revealed that she was suffering from three infectious conditions, namely dengue fever, chikungunya and scrub typhus. Doctors were shocked at the apparent rarity of the coinfection. Kiran died after a short stay of a few days at the hospital while undergoing treatment.

While coinfection is rare, it had actually occurred in the same hospital just days previously. Mukesh, aged 23, from Baswa of Dausa district, was brought to the SMS hospital suffering the exact same symptoms that would take the life of Kiran days later. Mukesh survived, but was found to have suffered the very same coinfection of diseases.

Scrub typhus alone is a rare condition. The disease is spread by mites, and had disappeared from the public eye for many decades due to it being both uncommon and typically limited to rural areas.

Both dengue fever and chikungunya are diseases spread by mosquitoes. They are not uncommon around the monsoon season as ample amounts of stagnant water allow mosquito populations to flourish. In the case of these diseases it would not be entirely improbable for a coinfection due to the transfer of diseases via the same vector.

The emergence of multiple cases of coinfection present a potential danger in the diagnosis of these diseases. Each of the three conditions — as well as many other infectious diseases — present very similar symptoms. Fevers and headaches are common among all diseases, often leaving them indistinguishable from each other.

This opens up the potential that individuals are being diagnosed with a single condition — and receiving treatment as appropriate — but actually harbouring more than one infection. This could be the case in many people who seemingly do not respond to initial treatment for an infectious disease.

The situation is not common, but in those cases where it does occur it may be difficult to counter, requiring swift examination by a medical professional and vigilance against coinfection to prevent cases like those of Kiran and Mikesh becoming the norm.

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