1887

Abstract

Introduction:

Dengue and meningococcal disease are caused by two different agents: a flavivirus and a Gram-negative bacterium, respectively. The first symptoms of both diseases can be indistinct and a rapid and accurate diagnosis is crucial, considering that both diseases are associated with high morbidity and mortality, representing a major public-health problem in Brazil.

Case presentation:

We report a fatal case of co-infection of dengue virus (DENV) and Neisseria meningitidis in a 54-year-old patient. The serum tested positive for DENV NS1 antigen, and N. meningitidis serogroup C was detected by nspA-PCR. Following the initial positive result for DENV infection, rRT-PCRwas performed and DENV-4 was confirmed.

Conclusion:

Our report highlights the importance of accurate differential diagnosis during periods of high circulation of DENV, in order to provide adequate management and an improved outcome.

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2016-08-01
2019-10-20
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References

  1. Brasil, Ministério da Saúde. SVS/MS ( 2015;). Perfil Epidemiológico da Meningite Brasil & Mundo. . http://www.saude.rs.gov.br/upload/1437759444_Perfil%20Epidemiol%C3%B3gico%20da%20Meningite%20Brasil%20&%20Mundo.pdf. Accessed on 25 May 2016.
  2. Brasil Ministério da Saúde SVS/MS ( 2016;). Informe epidemiológico da dengue – casos de dengue no Brasil, 1990 a 2014. . http://portalsaude.saude.gov.br/images/pdf/2015/julho/29/Dengue-at---2014.pdf. Accessed on 19 May 2016.
  3. Coureuil M. , Join-Lambert O. , Lécuyer H. , Bourdoulous S. , Marullo S. , Nassif X. . ( 2013;). Pathogenesis of meningococcemia. . Cold Spring Harb Perspect Med 3::a012393. [CrossRef] [PubMed]
    [Google Scholar]
  4. de Filippis I. , do Nascimento C. R. , Clementino M. B. , Sereno A. B. , Rebelo C. , Souza N. N. , Riley L. W. . ( 2005;). Rapid detection of Neisseria meningitidis in cerebrospinal fluid by one-step polymerase chain reaction of the nspA gene. . Diagn Microbiol Infect Dis 51: 85–90.[CrossRef]
    [Google Scholar]
  5. Gasparini R. , Amicizia D. , Lai P. L. , Panatto D. . ( 2012;). Neisseria meningitidis, pathogenetic mechanisms to overcome the human immune defences. . J Prev Med Hyg 53: 50–55.[PubMed]
    [Google Scholar]
  6. Gorla M. C. , de Paiva M. V. , Salgueiro V. C. , Lemos A. P. , Brandão A. P. , Vázquez J. A. , Brandileone M. C. . ( 2011;). Antimicrobial susceptibility of Neisseria meningitidis strains isolated from meningitis cases in Brazil from 2006 to 2008. . Enferm Infecc Microbiol Clin 29: 85–89. [CrossRef] [PubMed]
    [Google Scholar]
  7. Lanciotti R. S. , Calisher C. H. , Gubler D. J. , Chang G. J. , Vorndam A. V. . ( 1992;). Rapid detection and typing of dengue viruses from clinical samples by using reverse transcriptase-polymerase chain reaction. . J Clin Microbiol 30: 545–551.[PubMed]
    [Google Scholar]
  8. Nagassar R. P. , Bridgelal-Nagassar R. J. , McMorris N. , Roye-Green K. J. . ( 2012;). Staphylococcus aureus pneumonia and dengue virus co-infection and review of implications of coinfection. . BMJ Case Rep 2012: bcr0220125804.
    [Google Scholar]
  9. Pérez Rodríguez N. M. , Galloway R. , Blau D. M. , Traxler R. , Bhatnagar J. , Zaki S. R. , Rivera A. , Torres J. V. , Noyd D. et al. ( 2014;). Case series of fatal Leptospira spp./dengue virus co-infections-Puerto Rico, 2010-2012. . AmJ Trop Med Hyg 91: 760–765. [CrossRef]
    [Google Scholar]
  10. Siqueira J. B.,. Jr , Martelli C. M. , Coelho G. E. , Simplicio A. C. , Hatch D. L. . ( 2005;). Dengue and dengue hemorrhagic fever, Brazil, 1981-2002. . Emerg Infect Dis 11: 48–53. [CrossRef] [PubMed]
    [Google Scholar]
  11. Srirangaraj S. , Kali A. , Vijayan S. . ( 2014;). Dengue co-infection in a blood stream infection caused by Stenotrophomonas maltophilia: a case report. . Australas Med J 7: 441–444. [CrossRef] [PubMed]
    [Google Scholar]
  12. Stephens D. S. , Greenwood B. , Brandtzaeg P. . ( 2007;). Epidemic meningitis, meningococcaemia, and Neisseria meningitidis . . Lancet 369: 2196–2210. [CrossRef] [PubMed]
    [Google Scholar]
  13. SVS/SES-RJ ( 2016;). Boletim Epidemiológico 004/2016. Governo do Estado do Rio de Janeiro. . http://riocomsaude.rj.gov.br/Publico/MostrarArquivo.aspx?C=DmjDDb%2BR24E%3D. Accessed on 25 May 2016.
  14. Tsai J. J. , Hsieh M. H. , Liu L. T. , Hsiao H. M. , Perng G. C. . ( 2013;). Mortality from septic shock in a dengue infected patient: a case report. . Southeast Asian J Trop Med Public Health 44: 623–629.[PubMed]
    [Google Scholar]
  15. Tzanakaki G. , Tsolia M. , Vlachou V. , Theodoridou M. , Pangalis A. , Foustoukou M. , Karpathios T. , Blackwell C. C. , Kremastinou J. . ( 2003;). Evaluation of non-culture diagnosis of invasive meningococcal disease by polymerase chain reaction (PCR). . FEMS Immunol Med Microbiol 39: 31–36. [CrossRef] [PubMed]
    [Google Scholar]
  16. van Panhuis W. G. , Hyun S. , Blaney K. , Marques E. T. A. Jr , Coelho G. E. , Siqueira J. B. , Tibshirani R. , da Silva J. B. Jr , Rosenfeld R. . ( 2014;). Risk of dengue for tourists and teams during the World Cup 2014 in Brazil. . PLoS Negl Trop Dis 8::e3063. [CrossRef] [PubMed]
    [Google Scholar]
  17. Varon J. , Chen K. , Sternbach G. L. . ( 1998;). Rupert Waterhouse and Carl Friderichsen: adrenal apoplexy. . J Emerg Med 16: 643–647. [CrossRef] [PubMed]
    [Google Scholar]
  18. Zambrano B. , San Martin J. L. . ( 2014;). Epidemiology of dengue in Latin America. . J Pediatric Infect Dis Soc 3: 181–182. [CrossRef] [PubMed]
    [Google Scholar]
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