Coinfection with dengue and hepatitis A complicated with infective endocarditis in a Yemeni patient: a case report

Coinfection with dengue and hepatitis A complicated with infective endocarditis in a Yemeni patient: a case report

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Abstract Introduction Coinfection with dengue and hepatitis A is rare and challenging for physicians since their clinical features can be overlapping.These infections are self-limiting but can become complicated by subsequent infective endocarditis.We report a case of infective endocarditis following a coinfection with dengue and hepatitis A.Case presentation A 17-year-old Yemeni male patient was admitted to the hospital complaining of yellowish discoloration of the skin and sclera associated with dark urine and a diffuse skin rash on the trunk and upper limbs followed by intermittent high-grade fever.

Coinfection was confirmed by hepatitis A immunoglobulin M and dengue immunoglobulin M.At the time of diagnosis, white blood cells were normal, with mild neutrophilia and thrombocytopenia along Flat Files with elevated C-reactive protein.Five days later, the patient was readmitted to the emergency department, complaining of high-grade Dishwasher Door Pushrod fever, fatigue, myalgia, nausea, and vomiting.A systolic heart murmur was heard, and infective endocarditis was confirmed by the visualization of two vegetations on the mitral valve and coagulase-negative staphylococci after blood culture.

Supportive therapies were initiated for hepatitis A and dengue fever, whereas infective endocarditis was treated with antibiotics for 4 weeks.The patient recovered completely from dengue, hepatitis A, and infective endocarditis.Conclusion In endemic areas, it is reasonable to screen for coinfection with dengue and hepatitis A since they are superimposed on each other.Subacute infective endocarditis may occur following initial dengue and hepatitis A coinfection, especially among patients with rheumatic heart disease.

An echocardiogram is a pivotal workup for evaluating a patient with persistent fever of unknown origin.