Atypical neurological manifestations of chikungunya fever: Two case reports

Mahto, Subodh Kumar; Gupta, Parakriti; Singh, Akanksha; Meena, R. C.

doi:10.4103/ijccm.ijccm_459_17

Cited by 14 publications

(6 citation statements)

References 5 publications

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“…Without the typical signs and symptoms and confounded by presence of non-specific symptoms such as sore throat and cough, clinicians made the diagnosis of undifferentiated fever, febrile convulsions, or URTI in 9 subjects. Also, CHIK may present atypically with diarrhea [24] or decreased consciousness [25]. These were present in 3 of our cases, which were misdiagnosed as enteritis and herpes simplex infection.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 71%

Chikungunya in Indonesia: Epidemiology and diagnostic challenges

Arif

Tauran

Kosasih³

et al. 2020

PLoS Negl Trop Dis

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BackgroundChikungunya virus (CHIKV) is often overlooked as an etiology of fever in tropical and subtropical regions. Lack of diagnostic testing capacity in these areas combined with co-circulation of clinically similar pathogens such as dengue virus (DENV), hinders CHIKV diagnosis. To better address CHIKV in Indonesia, an improved understanding of epidemiology, clinical presentation, and diagnostic approaches is needed. Methodology/Principal findingsAcutely hospitalized febrile patients �1-year-old were enrolled in a multi-site observational cohort study conducted in Indonesia from 2013 to 2016. Demographic and clinical data were collected at enrollment; blood specimens were collected at enrollment, once during days 14 to 28, and three months after enrollment. Plasma samples negative for DENV by serology and/or molecular assays were screened for evidence of acute CHIKV infection (ACI) by serology and molecular assays. To address the co-infection of DENV and CHIKV, DENV cases were selected randomly to be screened for evidence of ACI. ACI was confirmed in 40/1,089 (3.7%) screened subjects, all of whom were DENV negative. All 40 cases initially received other diagnoses, most commonly dengue fever, typhoid fever, and leptospirosis. ACI was found at five of the seven study cities, though evidence of prior CHIKV exposure was observed in 25.2% to 45.9% of subjects across sites. All subjects were assessed during hospitalization as mildly or moderately ill, consistent with the Asian genotype of PLOS NEGLECTED TROPICAL DISEASES

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Section: Plos Neglected Tropical Diseasesmentioning

confidence: 71%

Chikungunya in Indonesia: Epidemiology and diagnostic challenges

Arif

Tauran

Kosasih³

et al. 2020

PLoS Negl Trop Dis

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“…17 Third nerve palsy has been associated with neuro-chikungunya, 6 but facial nerve palsy has been rarely reported. 18 The peripheral blood picture was unremarkable as in most CHIKV infections 19 except in case 4 who showed marked thrombocytopenia. Cerebrospinal fluid pleocytosis, which is not a consistent feature for CHIKV encephalitis, 9 was observed in all three cases with available CSF data.…”

mentioning

confidence: 88%

“…All specimens were optimally maintained at the collection sites, shipped and stored at the Eijkman Institute at 280 C for retrospective testing with the exception of the diagnostic specimen from Jambi, which was kept at 220 C before shipping. This study was approved by the Medical Research Ethics Committee of R. D. Kandou General Hospital (066/EC-UPKT/III/2016), Ethics Committee of Faculty of Medicine Universitas Indonesia (1365/UN2.F1/ETIK/2018), Eijkman Institute for Molecular Biology Research Ethics Commission (78), and Oxford Tropical Research Ethics Committee (13)(14)(15)(16)(17)(18)(19).…”

mentioning

confidence: 99%

Neurological Disease Associated with Chikungunya in Indonesia

Myint

Mawuntu

Haryanto

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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Chikungunya virus (CHIKV) is recognized but rarely considered as a cause of central nervous system infection in endemic areas. A total of 244 patients with acute meningoencephalitis in Indonesia were retrospectively tested to identify whether any CHIKV infection was associated with neurological manifestations, especially in provinces known for CHIKV endemicity. Cerebrospinal fluid and blood specimens were tested using CHIKV-specific real-time reverse transcription polymerase chain reaction and IgM ELISA, alongside a panel of neurotropic viruses. We report four cases of suspected or confirmed CHIKV-associated neurological disease, including CHIKV RNA detection in cerebrospinal fluid (CSF) of one patient and in acute serum of another, and CHIKV IgM in CSF of three patients and in serum of a fourth. In conclusion, CHIKV should be considered as a cause of neurologic disease in endemic areas and especially during outbreaks, in addition to the more common arboviral diseases such as dengue and Japanese encephalitis viruses.

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“…Outbreaks from different regions showed a similar clinical outcome, compromising the joints in the long term [ 5 , 13 , 14 , 15 , 16 ]. Atypical manifestations such as skin pigmentation, ulcers, chest pain, and ocular and neurological symptoms are described during the acute phase [ 17 , 18 , 19 ], and lethal complications such as myocarditis, hepatitis, and encephalitis have also been reported [ 20 , 21 ]. Children, who tend to be more vulnerable to central nervous system infections [ 8 ], present more neurologic manifestations when compared to adults [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Antiviral and Virucidal Activities of Uncaria tomentosa (Cat’s Claw) against the Chikungunya Virus

de Lima,

Valente,

Familiar Macedo

et al. 2024

Viruses

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Uncaria tomentosa (UT) is a medicinal plant popularly known as cat’s claw belonging to the Rubiaceae family that has been reported to display antiviral and anti-inflammatory activities. The chikungunya virus (CHIKV) outbreaks constitute a Brazilian public health concern. CHIKV infection develops an abrupt onset of fever, usually accompanied by a skin rash, besides incapacitating polyarthralgia. There is no vaccine available or treatment for CHIKV infection. The present study evaluates the hydroalcoholic extract of UT bark as a potential antiviral against CHIKV. The in vitro antiviral activity of the UT extract against the Brazilian CHIKV strain was assessed using quantitative reverse transcription polymerase chain reaction, flow cytometry, and plaque assay. Results obtained demonstrated that UT inhibits CHIKV infection in a dose-dependent manner. At the non-cytotoxic concentration of 100 µg/mL, UT exhibited antiviral activity above 90% as determined by plaque reduction assay, and it reduced the viral cytopathic effect. Similarly, a significant virucidal effect of 100 µg/mL UT was observed after 24 and 48 h post-infection. This is the first report on the antiviral activity of UT against CHIKV infection, and the data presented here suggests UT as a potential antiviral to treat CHIKV infection.

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Atypical neurological manifestations of chikungunya fever: Two case reports

Cited by 14 publications

References 5 publications

Chikungunya in Indonesia: Epidemiology and diagnostic challenges

Chikungunya in Indonesia: Epidemiology and diagnostic challenges

Neurological Disease Associated with Chikungunya in Indonesia

Antiviral and Virucidal Activities of Uncaria tomentosa (Cat’s Claw) against the Chikungunya Virus

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