Dual Infection by Dengue Virus andShigellasonneiin Patient Returning from India

To the Editor: Two days after returning from a 4-week trip in India, a 44-year-old woman was admitted to a local French hospital with diarrhea and a fever (40°C). The fever had started 2 days before her return and was associated with myalgia and backache. The patient had not been vaccinated against yellow fever and did not take malaria prophylaxis during her trip. Blood smears were negative for malaria parasites. Biological analyses (complete blood count, liver enzymes, urine culture, stool culture, blood cultures) were ordered. She was sent home with an empirical treatment with ofloxacin (200 mg per day). Biological parameters were within the normal range, except for her platelet count, which was at the lower limit (170 G/L). Microbiologic analyses of stools yielded an isolate of Shigella sonnei serotype 9.