Atypical manifestations of chikungunya in febrile infant: Case report
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Abstract
Introduction: Chikungunya is an arboviral disease caused by chikungunya virus transmitted by female mosquitoes infected with Aedes aegypti and A. albopictus. The main clinical manifestation of this acute febrile syndrome is a severe polyarthralgia which is often associated with edema and may persist after the acute phase of the disease. Atypical clinical findings as dermatosis, meningoencephalitis, pericarditis and retinitis are more frequently observed in infants and elderly. Objective: Reporting a case of a three-month-old patient with atypical manifestations of chikungunya, highlighting the relevance of this arboviral disease in differential diagnosis of febrile infants. Case description: Three-month-old male infant admitted with fever associated with irritability and diffuse erythema. Ceftriaxone was initiated after lumbar puncture due to persistent fever of unknown origin. During hospitalization, the patient presented blistering lesions on limbs suggestive of atypical form of chikungunya which was confirmed by the reverse transcription polymerase chain reaction
assay on blood sample. The transthoracic echocardiogram revealed pericardial effusion without hemodynamic repercussion. The infant was discharged with good clinical evolution without secondary cutaneous infection. Discussion: The current epidemiological situation in Brazil and the higher frequency of atypical manifestations of chikungunya in infants highlight the relevance of clinical suspicion of this arboviral disease in acute febrile syndromes which represent a
diagnostic challenge in infants.
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