CORRESPONDENCE Year : 2022  |  Volume : 23  |  Issue : 3  |  Page : 265

Chikungunya Rickettsial Coinfection

Pathum Sookaromdee1, Viroj Wiwanitkit2
1 Private Academic Consultant, Bangkok, Thailand
2 Depatment of Community Medicine, Dr DY Patil University, Pune, Maharashtra, India

Date of Submission24-Nov-2021Date of Decision30-Nov-2021Date of Acceptance26-Dec-2021Date of Web Publication30-Jun-2022

Correspondence Address:
Pathum Sookaromdee
Private Academic Consultant, Bangkok
Thailand

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/ijpd.ijpd_164_21

How to cite this article:
Sookaromdee P, Wiwanitkit V. Chikungunya Rickettsial Coinfection. Indian J Paediatr Dermatol 2022;23:265

Dear Editor, we would like to share ideas on “Chikungunya rickettsial coinfection with fatal outcome: A diagnostic dilemma.[1]” Srinivas et al. concluded that “This case highlights the need for a high degree of suspicion for coinfections … with febrile illness with multiorgan failure especially in tropical countries.[1]” We agree that concurrent infection is possible. In tropical medicine, concurrent infection is not uncommon but it might be underdiagnosed. In a tropical country, a variety of infections can cause acute febrile illness and concurrent infection is not uncommon.[2] The present case is a good example. The clinical pictures of the present might be difficult for definitive diagnosis and the laboratory investigation plays an important role. In our setting, the tropical area and the clinical presentation, including skin presentation, of tropical infection are usually similar, and the differential diagnosis is usually difficult. A complete laboratory profile covering common tropical bacterial, viral, and parasitic infection is usually used for diagnosis. An early diagnosis is important. Although Srinivas et al. highlighted the importance of investigation in a case with multiple problems, we would like to add that early diagnosis is important and the complete investigation should be done in any case regardless of multi-organ problem or not.

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  References 
1.Srinivas SM, Vijayasuriar S, Chandrasekaran P, Lakshmikantha KM. Chikungunya rickettsial coinfection with fatal outcome: A diagnostic dilemma. Indian J Paediatr Dermatol 2021;22:360-2.  
  [Full text]  2.Moreira J, Bressan CS, Brasil P, Siqueira AM. Epidemiology of acute febrile illness in Latin America. Clin Microbiol Infect 2018;24:827-35.