Varied Clinical Manifestations of Chikungunya—A Case Series

Abstract

Aim and objective: The aim and objective of this study is to report varied clinical manifestations of chikungunya amongst different pediatric age groups. Background: Chikungunya is an arboviral disease transmitted by Aedes mosquitoes, which has caused epidemic outbreaks in the past. The clinical manifestations vary widely among neonate, infant, and pediatric age groups. Case descriptions: We report four cases (two neonatal and two pediatric cases) of chikungunya. Neonates in this case series had predominant neurological and cutaneous manifestations. The older age groups in this series however had circulatory and cutaneous manifestations. All children reported in this case series had fever, lethargy, and thrombocytopenia. Chikungunya was confirmed by CHIKv PCR in all the cases. All cases reported recovered with appropriate neonatal/pediatric intensive care management. Conclusion:The spectrum of chikungunya disease is different in neonates and infants as compared to older children. Though it is predominantly a benign illness, its presentation can mimic commonly seen emergencies like viral encephalitis or septic shock. A high index of clinical suspicion is necessary for diagnosis. Clinical significance: Chikungunya should be considered as a differential diagnosis in neonates presenting with fever, typical hyperpigmentation, and encephalopathy. Neonates born to mothers with chikungunya should be closely observed for symptoms in the 1st week of life. Children, unlike adults, can have more of hematological and cutaneous than rheumatological manifestations. Management of chikungunya is predominantly symptomatic. Early clinical diagnosis can avoid irrational use of antibiotics.

Characteristics of acute chikungunya virus infection in children: an epidemiological study in the Department of Caaguazú, Paraguay

“…The importance of further exploring the disease in diverse age groups, particularly infants, has been highlighted by research findings. Robin et al 25 27 . These studies collectively contribute to the comprehension of the diverse clinical aspects of CHIKV infection in pediatric populations.…”