Quadruple Co-Infections due to Leptospira, Dengue, Hepatitis E & Round Worm: A Window to Urban Insanitary

Co-infection in a immune competent host is rare. Leptospirosis, Dengue, Hepatitis E and Ascariasis are diseases commonly transmitted in locales with poor hygiene and sanitation and overcrowding. Not too many cases of quadruple co-infection in an immune competent host have been reported. We report a case of mixed infection due to leptospira, dengue, hepatitis E and Ascariasis. Like clinical presentation and simultaneous transmission of these diseases, especially during the monsoon often leads to a dilemma in diagnosis. Early detection of the disease by appropriate laboratory tests and timely institution of therapy is pivotal and life saving.