TITLE:
Double Trouble in a Tropical Paradise
AUTHORS:
Adelyn Henry, Ganesh Kasinathan
KEYWORDS:
Typhoid Fever, Leptospirosis, Antibiotics, Waterfall, Septic Shock
JOURNAL NAME:
Open Access Library Journal,
Vol.5 No.1,
January
29,
2018
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.