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Published on: July 9, 2011
Cluster of Staphylococcus aureus and dengue co-infection in Singapore
Louis Y A Chai1, Poh-Lian Lim, Cheng-Chuan Lee
1Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.
Introduction:
Singapore saw a resurgence of dengue infections in 2005. Concurrent bacterial co-infections in dengue is rare.
Clinical Picture:
We report a cluster of serious methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia or severe soft tissue infection in 5 epidemiologically linked construction workers presenting with dengue and non-resolving fever.
Treatment:
Surgical intervention was indicated in 4 of the 5 patients despite appropriate antistaphylococcal therapy.
Outcome:
All but 1 patient were eventually discharged. Clonality and Panton-Valentine leucocidin genes were not demonstrated. Epidemiological investigations suggested that occupational contact dermatitis could have predisposed the patients to this opportunistic co-infection.
Conclusion:
Clinicians need to be vigilant to unusual manifestations of dengue which may signal a concomitant aetiology.
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