Leptospirosis and scrub typhus co–infection in febrile patients

Leptospirosis has to be differentiated from other aetiologies of acute febrile illness like scrub typhus, malaria, enteric fever, dengue and spotted fever. Concurrent infection of leptospirosis can occur with typhoid fever, brucellosis and rickettsial infections. A study was done in a tertiary care centre in Eastern India to determine simultaneous presence of infection of leptospirosis and scrub typhus in sera of febrile patients. IgM antibodies to both leptospira and scrub typhus were detected by Enzyme linked immunosorbant assay (ELISA). During the study period of two years a total of 608 serum samples were received for serology for leptospirosis. Out of these samples 26 patients had IgM antibodies to leptospira, of which 11 (42.31%) also had IgM antibodies to scrub typhus. As both leptospirosis and scrub typhus present with similar clinical features, co-infection of these two diseases may occur and it requires molecular methods for confirmation of these cases.