Introduction
Dengue is a tropical disease which is primarily caused by Aedes
aegypti and Aedes albopictus . It is particularly prevalent in tropical
and subtropical regions, and has been expanding into new geographic
areas throughout time 1.
Scrub typhus, which is caused by the bacteria Orientia
tsutsugamushi , is another disease to be concerned aboutdue to its
endemicity in Nepal. The lack of distinct clinical symptoms and
diagnostic resources, scrub typhus is frequently under-diagnosed2. Another endemic
febrile sickness in Nepal is typhoid fever; causative agentSalmonella typhi, and causes multi-systemic illness when
contaminated food and water is consumed3.
Monsoon and post-monsoon is a high risk season for spreading of typhoid,
dengue, and scrub-typhus4. Even though, the
co-infections among the organisms are rare due to multiple etiological
agents and/or vector involved, the probability cannot be neglected.
Here, we present a case of 58 years old female from Dang, a district
with sub-tropical climate, having co-infection of dengue, typhoid fever,
and scrub typhus during dengue outbreak in Nepal.