key: cord-0715837-vr1eickk
authors: Ratnarathon, Anuttra C.; Pongpirul, Krit; Pongpirul, Wannarat A.; Charoenpong, Lantharita; Prasithsirikul, Wisit
title: Potential Dual Dengue and SARS-CoV-2 Infection in Thailand: A Case Study
date: 2020-06-09
journal: Heliyon
DOI: 10.1016/j.heliyon.2020.e04175
sha: 8742d218241d827cf3a38588eaf5f7baa0fbc0c2
doc_id: 715837
cord_uid: vr1eickk

Public health; Epidemiology; Occupational health; Infectious disease; Virology; COVID-19; SARS-CoV-2; Dengue

The written informed consent for service was obtained from the patient.

Coronavirus disease 2019 (Covid-19) has non-specific clinical and laboratory characteristics 1 that might be similar to other viral infection including dengue. Two Covid-19 cases with 'falsepositive' dengue serology have been reported in Singapore but no public health consequence was described 2 . We describe a Thai patient with an initial diagnosis of dengue fever who was later confirmed to be co-infected with SARS-CoV-2. The Covid-19 infection appeared to spread to one family member and one healthcare worker.

A 35-year-old salesman with no underlying past medical history, no history of recent travel abroad, but had frequent encounters with Chinese tourists, developed a high-grade fever, myalgia, productive cough, and nausea and vomiting on January 25, 2020. He went to a local private hospital on January 28 and was prescribed some medications for his symptoms.

On January 30, 2020, he went to another private hospital because his symptoms deteriorated. His blood cell counts were within normal ranges (white blood cells 7.5x10 3 /ul, neutrophils 84%, lymphocytes 12%, hemoglobin 13.6 g/dl, hematocrit 39.8%, platelet 184x10 3 /ul) and tested positive for both dengue IgM and IgG but negative dengue NS1 antigen.

Nasopharyngeal swab tested negative for influenza A, influenza B, and respiratory syncytial virus. Chest radiography revealed minimal reticular infiltration and he was admitted for a provisional diagnosis of dengue fever. On February 2, he developed dyspnea and had persistent fever, thrombocytopenia (140x10 3 /ul), lymphopenia (1. The delayed diagnosis of Covid-19 because of the positive dengue rapid tests led to spreading the virus to a 35-year-old nurse who wore gloves but did not wear a mask during the blood sampling and his 3-year-old daughter. The nurse was considered the first Thai healthcare worker who got Covid-19 infection. His wife, mother, 10 work colleagues and 24 hospital staff tested negative for Covid-19.

Clinical Characteristics of Coronavirus Disease 2019 in China

Covert COVID-19 and false-positive dengue serology in Singapore. The Lancet Infectious Diseases