Concurrent Infection with SARS-CoV-2 and Orientia tsutsugamushi during the COVID-19 Pandemic in the Maldives
Issued Date
2023-02-01
Resource Type
eISSN
24146366
Scopus ID
2-s2.0-85149213899
Journal Title
Tropical Medicine and Infectious Disease
Volume
8
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
Tropical Medicine and Infectious Disease Vol.8 No.2 (2023)
Suggested Citation
Dey R.K., Imad H.A., Aung P.L., Faisham M., Moosa M., Hasna M., Afaa A., Ngamprasertchai T., Matsee W., Nguitragool W., Nakayama E.E., Shioda T. Concurrent Infection with SARS-CoV-2 and Orientia tsutsugamushi during the COVID-19 Pandemic in the Maldives. Tropical Medicine and Infectious Disease Vol.8 No.2 (2023). doi:10.3390/tropicalmed8020082 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/81945
Title
Concurrent Infection with SARS-CoV-2 and Orientia tsutsugamushi during the COVID-19 Pandemic in the Maldives
Other Contributor(s)
Abstract
The COVID-19 pandemic was the worst public-health crisis in recent history. The impact of the pandemic in tropical regions was further complicated by other endemic tropical diseases, which can cause concurrent infections along with COVID-19. Here, we describe the clinical course of a patient with concurrent COVID-19 and scrub typhus infection. The patient’s de-identified clinical data were retrieved retrospectively. The patient had progressive breathlessness at the time of presentation and was hospitalized for COVID-19. Respiratory examination revealed dyspnea, tachypnea, and coarse crepitations bilaterally over the entire lung field. Oxygenation was impaired, and a PaO2/FiO2 ratio of 229 suggested acute respiratory distress syndrome. Laboratory tests indicated leukocytosis, thrombocytopenia, ferritinemia, hypoalbuminemia, and transaminitis. Upon revaluation for persistent fever, physical examination revealed an eschar in the right antecubital fossa. Serology further confirmed scrub typhus, with IgM and IgG antibody positivity. A remarkable clinical recovery was achieved with doxycycline. The COVID-19 pandemic might have masked endemic tropical diseases. Clinicians working in endemic regions must always consider common tropical diseases that may present as a co-infection, as in our case. Travel and exposure history are critical guides for narrowing down a differential diagnosis. Early diagnosis and treatment can prevent complications.