Leptospirosis y rickettsiosis reto diagnóstico en zonas endémicas de síndrome febril: Reporte de un caso

A case of a 50 years-old male, from the Uraba region, Colombia with Rickettsia rickettsii and Leptospira interrogans serovar Copenhageni ST78 mixed infection, with negative test for malaria and dengue fever is reported. The patient presented a febrile syndrome, unresponsive to systemic antibiotic treatment and progressed to a fatal outcome in the intensive care unit (ICU). Postmortem diagnosis through molecular typification of the two etiological agents was performed. In the study case carried out in the patient’s living place, a specimen of Rattus rattus was identified infected with L. interrogans of the same serovar found in the previously deceased patient was detected. Ticks were not found to parasitize domestic animals cohabitating with the patient. This case reports a mixed infection with progressive and fatal symptoms, in a patient with an occupational risk history in an endemic zone for tropical diseases. This case highlighted the importance to consider the potential presentation of simultaneous etiologies in patients with multiple medical visits for an unresolved febrile syndrome associated with a risk exposure related to agricultural activities.