Zika and chikungunya virus infections in hematopoietic stem cell transplant recipients and oncohematological patients

Abstract

Key Points This article describes the first reports of Zika and chikungunya infections in HSCT recipients and oncohematological patients. Fever and exanthema should prompt arbovirus diagnosis, especially in areas at risk or in patients returning from endemic or epidemic regions.

Chikungunya in solid organ transplant recipients, a case series and literature review

“…However, in our case series none of the SOT recipients developed severe complications as a result of CHIKV infection despite the presence of some of these risk factors. Additionally, none of the patients developed graft rejection, which is consistent with the reports in the literature that do not show any fatal or complicated cases, suggesting a more benign course of the infection …”

“…Mild or transient arthralgia and fever were the most common symptoms observed in our case series of SOT recipients with CHIKV infection, which is consistent with published reports . Among all case series reviewed, arthralgia lasting more than 5 days was present in 30%‐46% of the SOT recipients with CHIKV infection . This rate is lower than that reported in non‐transplant patients with CHIKV infection, in whom arthralgia lasting more than 5 days has been reported in 80% of patients .…”

“…1,18,19 Among all case series reviewed, arthralgia lasting more than 5 days was present in 30%-46% of the SOT recipients with CHIKV infection. 14,15,[19][20][21] This rate is lower than that reported in non-transplant patients with CHIKV infection, in whom arthralgia lasting more than 5 days has been reported in 80% of patients. 22 The duration of joint involvement can be classified into three groups; acute (<2 weeks), subacute (2-6 weeks), and chronic (>6 weeks).…”

“…Additionally, none of the patients developed graft rejection, which is consistent with the reports in the literature that do not show any fatal or complicated cases, suggesting a more benign course of the infection. 14,19,21,26,27 Kee et al 15…”

Imported Arbovirus Infections in Spain, 2009–2018

“…Case descriptions report uncomplicated outcomes, whereas a recent literature review reported a significantly higher incidence of severe dengue and a higher mortality rate among transplant patients with dengue (21)(22)(23). A recent report of DENV, ZIKV, and CHIKV infections diagnosed in hematopoietic stem cell transplant recipients and oncohematologic patients found prolonged viremia in those with DENV and viruria in those with ZIKV; the most common complication was thrombocytopenia, but all patients survived without sequelae (24). However, other case reports reveal less favorable outcomes and even atypical presentations: a fatal pseudotumoral form of ZIKV meningoencephalitis in a heart transplant recipient has been reported (25).…”