Clinical and histopathological features of fatal cases with dengue and chikungunya virus co-infection in Colombia, 2014 to 2015

Abstract

histopathological features of fatal cases with dengue and chikungunya virus co-infection in Colombia, 2014. Euro Surveill. 201621(22) We report clinical features and histopathological findings in fatal cases with dengue (DENV) and chikungunya (CHIKV) co-infection identified at the Colombian National Institute of Health between September 2014 and October 2015. Seven such cases were documented. Dengue serotype 2 virus was identified in six cases. All patients were adults and comorbidities were present in four. Fever, arthralgia or myalgia was present in all cases. The frequency of rash, haemorrhage, oedema, and gastrointestinal symptoms was variable. Laboratory findings such as thrombocytopenia, renal failure, and leukocyte count were also inconsistent between cases. Post-mortem tissue examination documented focal hepatocellular coagulative necrosis in three cases, incipient acute pericarditis in one and tubulointerstitial nephritis in one. This study provides evidence of mortality in patients with DENV and CHIKV co-infection. Fatal cases were characterised by variable clinical and laboratory features. Evaluation of histopathology of autopsy tissues provided evidence of the pathological consequences of the disease.

Zika Virus Infection in Dexamethasone-immunosuppressed Mice Demonstrating Disseminated Infection with Multi-organ Involvement Including Orchitis Effectively Treated by Recombinant Type I Interferons

“…Clinical studies to confirm the presence of orchitis and to assess the fertility of convalescent male patients should be conducted to ascertain the long-term consequences of ZIKV infection regarding reproductive and hormonal derangements. Inflammation of other organs, such as acute tubulitis, interstitial nephritis, sialadenitis, hepatitis, enteritis, and acute pancreatitis have been reported in patients with ZIKV or other flavivirus infections (Chan et al, 2016a;Sarmiento-Ospina et al, 2016;Arzuza-Ortega et al, 2016;Duijster et al, 2016;Bonaldo et al, 2016;Gourinat et al, 2015;Musso et al, 2015b;Mercado et al, 2016;Bhagat et al, 2012;Torres et al, 2000;Macnamara, 1954;Chatterjee et al, 2014). These potential complications may be increasingly recognized as the ZIKV epidemic continues to expand into developed countries with a large ageing and immunosuppressed population.…”

Case Report: An Acute Chikungunya Infection and a Recent Secondary Dengue Infection in a Peripartum Case in Ecuador

“…10,11 There have been reports of coinfection of CHIKV and DENV with variable laboratory values and symptoms. 1,5,6 Coinfections with ZIKV, DENV, and CHIKV have also been reported, representing the challenge of diagnosing these arboviral infections, especially for high-risk groups, such as pregnant women in endemic areas. 12 It is critically important to assess the risks of CHIKV and DENV infections during pregnancy.…”

“…4 Prior studies indicate the risk of more severe DENV and CHIKV infections during pregnancy. [5][6][7][8] However, the ramifications of acute CHIKV infection in the setting of recent secondary DENV during pregnancy are unclear. Here we report the case of a pregnant woman who was admitted to the hospital with a diagnosis of suspected DENV and CHIKV and gave birth.…”

Impact of Chronic Kidney Disease on Chikungunya Virus Infection Clinical Manifestations and Outcome: Highlights during an Outbreak in Northeastern Brazil

“…There are very few studies describing kidney involvement in chikungunya infection. 5,6 In a study of autopsies of patients who had kidney injury due to CHIKV infection, there were glomerular changes, with predominance of nephrosclerosis and membranoproliferative lesion, and tubular injury, mainly acute tubular necrosis. 5,6 Other investigations evidence that CHIKV can lead to albuminuria, hematuria, nephritis, acute kidney injury, and other renal function abnormalities.…”

“…5,6 In a study of autopsies of patients who had kidney injury due to CHIKV infection, there were glomerular changes, with predominance of nephrosclerosis and membranoproliferative lesion, and tubular injury, mainly acute tubular necrosis. 5,6 Other investigations evidence that CHIKV can lead to albuminuria, hematuria, nephritis, acute kidney injury, and other renal function abnormalities. 7 Among kidney-transplanted patients, the course of CHIKV infection was observed to be less severe, with milder arthralgia, a fact that could be attributed to the effects of the immunosuppressant drugs routinely used in the post-transplantation period.…”