Short Report: Coinfection with Leptospirosis and Scrub Typhus in Taiwanese Patients

Abstract. We retrospectively analyzed patients with leptospirosis (n 35), scrub typhus (n 45), and coinfection (leptospirosis and scrub typhus [n 7]) to facilitate the detection of coinfection. Our data showed that factors favoring these disease entities included animal contact, an aspartate aminotransferase/alanine aminotransferase ratio> 2 (for leptospirosis); outdoor exposure, lymphadenopathy, splenomegaly, eschar, and elevated alkaline phosphatase levels (for scrub typhus and coinfection); calf tenderness, conjunctival suffusion, jaundice, oliguria, elevated total bilirubin levels and serum creatinine levels (for leptospirosis and coinfection); and maculopapular rash (for scrub typhus). Patients at risk for leptospirosis are often at increased risk for scrub typhus and vice versa. Lack of knowledge of coinfection may jeopardize the health of affected patients. Our study serves as a reminder of potential coinfection and provides clues for its detection. Leptospirosis, a common spirochetal zoonosis that is dis-tributed worldwide with particular high incidences in tropical and subtropical areas,1,2 was once ignored in Taiwan.3,4 How-ever, because of progressively widespread clinicians ’ aware-ness, a substantially higher number of cases of leptospirosis were recently reported on this island.4,5 Fatality rates in case