Concomitant Triple Infection Of Dengue, Malaria And Enteric Fever - A Rare Case Report.

Dengue, malaria and enteric fever are the important causes of fever in Maharashtra especially during rainy season. Each of these diseases can substantially contribute to mortality if not diagnosed and treated early. Co-infection of dengue with malaria, other viral infections, enteric fever, leptospira etc has been described in many parts of the world but triple infection with dengue, malaria and enteric fever in the same patient is very uncommon. We report a rare case of 38 year old male, who came to our hospital for continuing fever of more than a week with rash, breathlessness and pain in abdomen. He was febrile, conscious and coherent and his other vitals were stable. His blood picture showed leucopenia and thrombocytopenia, while other biochemical tests were normal. Dengue NS1antigen and IgM ELISA were positive. Malarial antigen was positive for P. falciparum and widal test showed a titre of TO-1:240 and TH- 1:240. His blood culture showed growth of Salmonella Typhi, confirming typhoid co-infection. He was treated with intravenous Atresunate, Ceftriaxone, along with symptomatic treatment. He responded to treatment and was discharged after near normalization of general condition.