In all cases of Rickettsia initially suspected to be leptospirosis, typhoid fever, chikungunya, or dengue fever, diagnostic assays for those pathogens at the reference laboratory were negative, except in one R. felis case where leptospira PCR was positive and leptospira IgM and IgG sero-converted, suggesting co-infection. This evidence concerns the gene CD40LG and dengue disease.