title: Clinical manifestations of co-infection with malaria and leptospirosis.
abstract: Though both malaria and leptospirosis are frequent in the tropics, co-infections are under-recognized due to overlapping of clinical features. Here, we reviewed clinical manifestations of published co-infection along with our three cases. Out of a total of 18 patients, nine patients (50%) required ICU admission. Almost all patients had prodromal symptoms in the form of fever, headache and myalgia. Seven patients (37%) had altered sensorium, three patients (17%) had hypotension at admission, and 11 patients (61%) had acute kidney injury (AKI). Pulmonary manifestations in the form of pulmonary bleeding were present in four cases (22%). Three (17%) patients had acute lung injury/ acute respiratory distress syndrome. Almost 55% patients had DIC in the form of altered prothrombin time, activated partial thromboplastin time and low fibrinogen level. Four patients (22%) had subconjuctival suffusion, two of them had haematuria, while one presented with nasal bleeding. All patients had altered liver function tests. Of all the 18 patients, 17 (94%) survived, while one died.
authors: Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) - Critical Care Medicine, SGPGIMS, Rae Bareli Road, Lucknow, UP 226014, India. m.gurjar@rediffmail.com
authors: Mohan
authors: M
authors: Gurjar
authors: Saurabh
authors: S
authors: Saigal
authors: Arvind K
authors: AK
authors: Baronia
authors: Afzal
authors: A
authors: Azim
authors: Banani
authors: B
authors: Poddar
authors: Ratender K
authors: RK
authors: Singh
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications; D055371:Acute Lung Injury; D000328:Adult; D005260:Female; D005334:Fever; D006801:Humans; D007194:India; D007362:Intensive Care Units; D007922:Leptospirosis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D016778:Malaria, Falciparum / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D016780:Malaria, Vivax / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000150:complications; D055815:Young Adult