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El diagn\u00f3stico post mortem se hizo mediante tipificaci\u00f3n molecular de los dos agentes etiol\u00f3gicos. En la inspecci\u00f3n del domicilio del paciente, se encontr\u00f3 un ejemplar de Rattus rattus infectado con L. interrogans del mismo serovar detectado en \u00e9l. No se encontraron garrapatas en los animales dom\u00e9sticos que habitaban con el paciente.Se reporta una infecci\u00f3n mixta con s\u00edntomas cl\u00ednicos progresivos y fatales en un paciente con antecedentes laborales de riesgo en una zona end\u00e9mica para enfermedades tropicales, lo que obliga a tener presente la posibilidad de infecciones simult\u00e1neas en personas procedentes de \u00e1reas end\u00e9micas que consulten reiteradamente por s\u00edndrome febril sin resoluci\u00f3n y tengan riesgo laboral relacionado con actividades agr\u00edcolas.<\/jats:p>","DOI":"10.7705\/biomedica.5598","type":"journal-article","created":{"date-parts":[[2021,6,30]],"date-time":"2021-06-30T13:20:29Z","timestamp":1625059229000},"page":"208-217","update-policy":"https:\/\/doi.org\/10.7705\/crossmark","source":"Crossref","is-referenced-by-count":9,"title":["Leptospirosis y rickettsiosis, reto diagn\u00f3stico para el s\u00edndrome febril en zonas end\u00e9micas"],"prefix":"10.7705","volume":"41","author":[{"given":"Ren\u00e9","family":"Ram\u00edrez-Garc\u00eda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Quintero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aixa Paola","family":"Rosado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Arboleda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor Alejandro","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piedad","family":"Agudelo-Fl\u00f3rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4444","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"103952","doi-asserted-by":"crossref","unstructured":"Karnad DR, Richards GA, Silva GS, Amin P, Council of the World Federation of Societies of Intensive and Critical Care Medicine. 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