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Double Trouble in a Tropical ParadiseDOI: 10.4236/oalib.1104325, PP. 1-4 Subject Areas: Internal Medicine Keywords: Typhoid Fever, Leptospirosis, Antibiotics, Waterfall, Septic Shock Abstract
Introduction: Leptospirosis and typhoid fever are
water borne diseases. These diseases present as acute undifferentiated fever
and often can be challenging to clinicians in the developing world due to
limited resources. Case Presentation: A 15-year-old Malay girl presented a week
after swimming in a waterfall with fever, vomiting and lethargy. Her condition
deteriorated into septic shock and respiratory distress requiring mechanical
ventilation. Her blood, urine and stool cultures grew pure isolates of Salmonella typhi. The leptospira
serology was positive and the leptospira microscopic agglutination test
revealed a high titre of 1:400. She was diagnosed with dual infections of
leptospirosis and typhoid fever. With third generation cephalosporin
antibiotics, she improved. There was clearance of her blood, urine and stool
cultures. Her leptospira microscopic agglutination test demonstrated a fourfold
reduction in titre. Conclusion: Not only do these illnesses prove challenging
to physicians to diagnose and treat due to their similarity in initial
presentation, they are also life threatening to the unknowing tourist or locals who went for an innocent dip in a picturesque waterfall.
Henry, A. and Kasinathan, G. (2018). Double Trouble in a Tropical Paradise. Open Access Library Journal, 5, e4325. doi: http://dx.doi.org/10.4236/oalib.1104325. References
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