title: Acute febrile hepato-renal dysfunction in the tropics: co-infection of malaria and leptospirosis.
abstract: Malaria and leptospirosis are both common in the tropics. Simultaneous infections are possible, although not frequently reported. We report two cases of malaria from India with compelling serologic evidence of coexistent acute leptospirosis. One was a case of infection with Plasmodium falciparum with acute and convalescent microscopic agglutination test titers for Leptospira serovar                         icterohaemorrhagiae of 1:200 and 1:1600, respectively. The other was a case of infection with Plasmodium vivax that seroconverted to a titer of 1:3200 for Leptospira serovar batavia. Both patients finally improved with cephalosporins and doxycycline after no significant clinical/biochemical improvement with antimalarials standalone. It is proposed that febrile patients with hepato-renal dysfunction should be considered possible co-infection of malaria and leptospirosis.
authors.affiliation: Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040, India.
authors.forename: Krishna Venkatesh
authors.initials: KV
authors.lastname: Baliga
authors.forename: Yanamandra
authors.initials: Y
authors.lastname: Uday
authors.forename: Vivek
authors.initials: V
authors.lastname: Sood
authors.forename: Akhil
authors.initials: A
authors.lastname: Nagpal
mesh_terms: D000328:Adult; D060085:Coinfection / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007919:Leptospira / Q000302:isolation & purification; D007922:Leptospirosis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D008099:Liver / Q000503:physiopathology*; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D010963:Plasmodium falciparum / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000302:isolation & purification; D014329:Tropical Climate