Clinical and laboratory profiles of children with severe chikungunya infection

Abstract

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.

Vesiculobullous exanthema in a 3-month-old child with probable acute chikungunya infection

“…Seetharam KA et al described 52 children diagnosed with CHIKV IgM serology in which 27 presented Vesiculobullous exanthema in a child with chikungunya 431 pigmentary cutaneous lesions, followed by vesiculobullous lesions (17/52) and maculopapular rash (16/52) 10 . Other case reports showed similar lesions with complete regression varying between two and five days 6,11 .…”

“…Other skin manifestations related to the virus are hyperpigmentation; multiple aphthous-like ulcers located over the scrotum, penis, groins, perianal region, axillae, and oral mucosa; transient nasal erythema; vesiculobullous lesions; ecchymosis; subungual hemorrhage; and generalized erythema 6 . Patients with dermatological comorbidities such as psoriasis, leprosy, urticaria or xerosis may exacerbate and recidivate during the infection 6,12 . Currently, novel dermatological manifestations attributed to CHIKV have been frequently in medical literature possibly due to Chikungunya outbreaks worldwide, including Brazil 6,13 .…”

“…Patients with dermatological comorbidities such as psoriasis, leprosy, urticaria or xerosis may exacerbate and recidivate during the infection 6,12 . Currently, novel dermatological manifestations attributed to CHIKV have been frequently in medical literature possibly due to Chikungunya outbreaks worldwide, including Brazil 6,13 .…”

“…It usually manifests as a benign and self-limited viral disease characterized by the triad: sudden fever, arthralgia/arthritis, and rash 2 . Atypical manifestations have been described in the literature affecting different organs and systems such as neurological, ophthalmologic and dermatological manifestations which can be severe or debilitating [3][4][5][6] Children and the elderly appear to be more affected by atypical manifestations 7,8 .…”

Association between vitiligo lesions and acute chikungunya infection: is there a causal relationship?

“…Chikungunya has become a public health problem, mainly because of the ability of CHIKV to cause chronic infection leading to an increase in the morbidity and mortality rates of affected individuals. In addition, CHIKV seems to be responsible for a myriad of atypical manifestations targeting different organs and systems, such as the cardiovascular, ophthalmologic, neurologic, and genitourinary systems, as well as the skin [2][3][4] .…”