Work

Oropouche fever: Clinical characteristics and viral–bacterial coinfections in a region of the Peruvian Amazon: A cross-sectional study

Year: 2025

Type: article

Abstract: • First Peruvian study of coinfections in Oropouche fever (OROV). • OROV+ Leptospira coinfection increases hospital length of stay. • Frequent mismatch between empiric antibiotics and final etiology. • OROV and OROV+DENV-2: Am/As II show indistinguishable clinical profiles. Co-circulation of OROV with other endemic pathogens means co-infections can occur. This study aimed to characterize viral and bacterial co-infections in OROV-positive patients, evaluating their clinical features and exploring the impact on hospital stay and antibiotic use across different infection groups. cross-sectional study in an eastern Peruvian Amazon region among patients with acute febrile illness who tested positive for OROV. Patients were stratified into five groups: OROV monoinfection, OROV+DENV-2: Am/As II co-infection, OROV+ Rickettsia coinfection, OROV+ Leptospira coinfection, and a control group of OROV-negative febrile patients. 75 patients were included. Patients with OROV+ Leptospira co-infection had the longest mean hospital stay (6.00 SD 1.40). Empirical antibiotic use at admission varied by group (overall 7/75, 9.3%). However, only 2 cases (both OROV+ Leptospira ) had appropriate antibiotic coverage for the confirmed pathogen. In all co-infected groups, there was frequent discordance between initial antibiotic treatment and the etiologic agent. Co-infection with Leptospira was described with a longer length of hospital stay and was the only scenario in which empiric antibiotic therapy aligned with the true etiology. OROV monoinfections and viral co-infections (with DENV-2 American/Asian II) showed similar clinical profiles, underscoring that routine clinical assessment alone cannot readily distinguish these infections or co-infections.

Source: IJID Regions

DOI: 10.1016/j.ijregi.2025.100802