Rare triple disease combination shocks docs

Jaipur: An uncommon combination of triple diseases — dengue, chikungunya and scrub typhus — has shocked SMS hospital doctors. Two such cases have already been reported in 11 days.
When a 63-year-old Kiran, was rushed to Sawai Man Singh Hospital from Kotputli of Jaipur district, she had double pneumonia, breathing problems, low platelet count and abnormal functioning of liver and kidneys.
She was brought to SMS hospital on August 19 and died on August 23 while undergoing treatment. When the doctors conducted diagnostic tests, they found that she tested positive for dengue, chikungunya and scrub typhus.
The rare combination of the triple diseases — dengue, chikungunya and scrub typhus, has shocked the SMS hospital doctors.
Two days before Kiran was rushed to SMS Hospital, a patient Mukesh (23), from Baswa of Dausa district, was brought to the hospital on August 17. The doctors immediately admitted him and began with the treatment. He has recovered and was discharged from the hospital on Monday.
Mukesh was brought to the hospital with high-grade fever and altered sensorium. The doctors provided him with treatment and he responded to the treatment well.
“Both the patients were brought to the hospital with a more or less similar condition — having double pneumonia, breathing problems, low platelet count and abnormal functioning of liver and kidneys. These complications can be found in a patient suffering from dengue, or chikungunya or scrub typhus. But when we conducted tests, we found that they (both patients) have a triple combination of these diseases. So it is quite necessary for doctors not to rule out other diseases, if a patient is tested positive for one disease,” said Dr C L Nawal, senior professor (medicine), SMS Hospital.
The cases of scrub typhus, which was termed as a ‘mysterious disease’, were reported first from Alwar district, almost 10 years ago. But the disease, which is caused by the bite of a mite, has started affecting other districts such as Dausa, Karauli, Dholpur, Bharatpur and also rural areas of Jaipur.
Now, it has started targeting its victims in combination with other vector-borne diseases.
A private hospital’s consultant physician Dr Adil Aziz said, “It is quite uncommon that we find a patient suffering from the three diseases — scrub typhus, chikungunya and dengue. We report combinations of diseases such as malaria plasmodium falciparum and malaria vivax, or malaria and dengue, but patients with scrub typhus, chikungunya and dengue at the same time, are very uncommon.”
The reason for cases of triple diseases being reported, could be a spurt in cases of scrub typhus. In SMS Hospital, 411 cases of scrub typhus have already been reported this year, and 415 cases of dengue were reported. However, chikungunya cases were only 11 in 2018 so far.
Box:
Triple Trouble:
— A combination of triple diseases is caused by infected mosquito bite and infected mite bite. Infected mosquito bite causes dengue and chikungunya and infected mite bite causes scrub typhus
—Scrub typhus is caused by biting of a mite, known as chigger
— It is a life-threatening infectious disease caused by bite of infected chigger, which are commonly found in grassy areas
— So far, six patients have died of scrub typhus in SMS Hospital in 2018
— broad spectrum antibiotics like doxycycline and chloramphenicol are being used by doctors for treatment of scrub typhus
— Fever and chills, headache, body aches and muscle pain, altered sensorium, are some of the symptoms of scrub typhus
— Chigger leaves a dark, scab-like region on the body part where it bites