Introduction: Chikungunya infection presents with distinct clinical features depending on the patient age group. Methods: Medical records of children with positive IgM for the chikungunya virus who were hospitalized in a pediatric ward in Fortaleza, Ceará, Brazil were analyzed. Results: Fourteen children with a median age of 4 months (36 days to 15 years) were included. All patients presented with fever persisting for an average of 5 days. The joints were involved in 6 (42.8%) children, and 8 (57.1%) children presented with bullous rash. Conclusions: Systemic involvement and atypical clinical manifestations characterize severe forms of chikungunya infection in children.