{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:37:59Z","timestamp":1790699879401,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n A 35\u2010year\u2010old female presented with 5\u2009days of fever, fatigue, and myalgia during the post\u2010monsoon season at Damak Hospital, Jhapa, Nepal. Clinical examination revealed fever (102.7\u00b0F), tachycardia (110\u2009bpm), and crackles in the right lower lung field. Laboratory investigations showed anemia (Hb 8.9\u2009g%), leukopenia (3300\/cumm), elevated liver enzymes (SGPT, 117\u2009IU\/L; SGOT, 94\u2009IU\/L; ALP, 391\u2009U\/L), and elevated CRP (18.58\u2009mg\/dL). ELISA testing demonstrated concurrent positivity for\n \n Salmonella typhi<\/jats:italic>\n <\/jats:styled-content>\n IgG\/IgM, scrub typhus IgM, and\n \n Brucella abortus<\/jats:italic>\n <\/jats:styled-content>\n antigens. Blood and urine cultures were negative. Abdominal ultrasonography revealed hepatosplenomegaly. The patient initially received ceftriaxone and doxycycline, without any response. Following serological evidence of brucellosis, rifampicin 600\u2009mg daily was added, and the patient became afebrile within 3\u2009days. The patient was discharged on doxycycline 100\u2009mg daily for 35\u2009days and rifampicin 600\u2009mg daily for 40\u2009days. At 3\u2010month follow\u2010up, clinical examination and laboratory tests confirmed complete recovery. This case highlights the diagnostic challenges posed by serological cross\u2010reactivity among endemic febrile illnesses in resource\u2010limited settings, emphasizing the need for cautious test interpretations and clinical correlations.\n <\/jats:p>","DOI":"10.1002\/ccr3.73376","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:47:37Z","timestamp":1787201257000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute Febrile Illness With Triple Co\u2010Infection: A Case Report on the Diagnostic Challenges of Overlapping Febrile Illnesses"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6898-9413","authenticated-orcid":false,"given":"Santosh","family":"Basyal","sequence":"first","affiliation":[{"name":"Nepal Medical College and Teaching Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0223-3185","authenticated-orcid":false,"given":"Rahul","family":"Parajuli","sequence":"additional","affiliation":[{"name":"Hospital for Advanced Medicine and Surgery Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2480-837X","authenticated-orcid":false,"given":"Dipendra Prasad","family":"Yadav","sequence":"additional","affiliation":[{"name":"B.P. Koirala Institute of Health Sciences Dharan Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7191-2130","authenticated-orcid":false,"given":"Shardul","family":"Bhattarai","sequence":"additional","affiliation":[{"name":"Nepal Medical College and Teaching Hospital Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7156-7604","authenticated-orcid":false,"given":"Kritick","family":"Bhandari","sequence":"additional","affiliation":[{"name":"KIST Medical College Lalitpur Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1926-1564","authenticated-orcid":false,"given":"Shrijana","family":"Basyal","sequence":"additional","affiliation":[{"name":"Nepal Army Institute of Health Sciences Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6851-2649","authenticated-orcid":false,"given":"Gul","family":"Zaman","sequence":"additional","affiliation":[{"name":"Khyber Teaching Hospital Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0934-8956","authenticated-orcid":false,"given":"Rohit","family":"Parajuli","sequence":"additional","affiliation":[{"name":"College of Medical Sciences Bhartpur Chitwan Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra050570"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid0302.970219"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed6020078"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10081-1297"},{"key":"e_1_2_12_6_1","unstructured":"\u201cMonsoon Preparedness Plan \u2013 2077 (2020) \u201dMinistry of Health and Population Government of Nepal 2020."},{"key":"e_1_2_12_7_1","volume-title":"Brucellosis in Humans and Animals","author":"Corbel M. 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