Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
Introduction: Arboviral infections, viral diseases transmitted by arthropods, represent a major public health concern in tropical regions. In Latin America, dengue virus (DENV) and yellow fever remain endemic, together with emerging viruses such as Zika and Chikungunya, as well as other arboviruses including Mayaro, Madariaga, and West Nile virus. In Ecuador, a sustained increase in dengue cases has been observed since 2023, along with the re-emergence of yellow fever. Coinfection between dengue and leptospirosis constitutes a diagnostic challenge due to the overlapping clinical manifestations of both entities. Case presentation: We report the case of a 38-year-old male patient with an epidemiological history of intrafamilial exposure to dengue who was admitted to the intensive care unit with seizures, jaundice, and mucosal bleeding. The patient rapidly progressed to refractory shock and multiorgan dysfunction involving neurological, cardiovascular, renal, hepatic, and hematological systems. Multiplex polymerase chain reaction (PCR) confirmed infection with dengue virus serotype 2 (DENV-2). Additionally, positive IgM antibodies against Leptospira interrogans were detected by automated ELISA, suggesting possible coinfection; however, no further confirmatory testing was available. Despite intensive supportive management, the patient died within 8 hours after ICU admission. Conclusion: Severe dengue may rapidly progress to refractory shock and multiorgan failure. The coexistence of findings compatible with leptospirosis highlights the diagnostic complexity of icterohemorrhagic febrile syndromes in endemic regions. Early recognition and a multidisciplinary approach are essential to optimize the management of these patients.
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