Abstract Introduction Coinfection with dengue and hepatitis A is rare and challenging for physicians since their clinical features can be overlapping.These infections are self-limiting but can become complicated by subsequent infective endocarditis.We report a case of infective endocarditis following a coinfection with dengue and hepatitis A.Case presentation A 17-year-old 15-eg2373cl Yemeni male patient was admitted to the hospital complaining of yellowish discoloration of the skin and sclera associated with dark urine and a diffuse skin rash on the trunk and upper limbs followed by intermittent high-grade fever.
Coinfection was confirmed by hepatitis A immunoglobulin M and dengue immunoglobulin M.At the time of diagnosis, white blood cells were normal, with mild neutrophilia and thrombocytopenia along with elevated C-reactive protein.Five days later, the patient was readmitted to the emergency department, complaining of high-grade fever, fatigue, myalgia, nausea, and vomiting.A systolic heart murmur was heard, and infective endocarditis was confirmed by the visualization of two vegetations on the mitral valve and coagulase-negative staphylococci after blood culture.
Supportive therapies were initiated for hepatitis A and dengue fever, whereas infective endocarditis was jolly rancher filled gummies treated with antibiotics for 4 weeks.The patient recovered completely from dengue, hepatitis A, and infective endocarditis.Conclusion In endemic areas, it is reasonable to screen for coinfection with dengue and hepatitis A since they are superimposed on each other.Subacute infective endocarditis may occur following initial dengue and hepatitis A coinfection, especially among patients with rheumatic heart disease.
An echocardiogram is a pivotal workup for evaluating a patient with persistent fever of unknown origin.