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Chikungunya encephalitis: report of a fatal case in Northeastern Brazil.

Abstract

Chikungunya, a viral infection that presents with fever, rash and polyarthritis, is usually an acute febrile illness. Uncommon neurological manifestations include meningoencephalitis, encephalitis, myelitis, Guillain-Barre syndrome, myelopathy and neuropathy. During an outbreak of the disease in La Reunion Island, abnormalities were observed in the magnetic resonance imaging (MRI) of patients with encephalitis and acute disseminated encephalomyelitis, showing bilateral, frontoparietal, white matter lesions with restricted diffusion, similar to our case. We report a 57-year-old male patient with comorbidities, admitted with high fever, arthralgia, asthenia, vomiting, psychomotor agitation, behavioral changes and seizures. Cerebrospinal fluid (CSF) values revealed pleocytosis (98 cells/mm3 with 68% lymphocytes and 12% monocytes) and high levels of protein (161 mg%). Brain MRI showed hyperintense lesions in the temporal and frontal lobes and bilaterally in the posterior thalamus. CSF serology was positive for IgM antibodies to Chikungunya virus. Encephalitis due to an acute viral infection by Chikungunya was diagnosed. The patient's clinical condition worsened and he died on the twenty-fourth day of admission to our hospital.

Authors+Show Affiliations

Universidade Federal de Pernambuco, Programa de Pós Graduação em Medicina Tropical, Recife, Pernambuco, Brazil.Secretaria de Saúde do Estado de Pernambuco, Hospital Correia Picanço, Recife, Pernambuco, Brazil.Secretaria de Saúde do Estado de Pernambuco, Hospital Correia Picanço, Recife, Pernambuco, Brazil.Secretaria de Saúde do Estado de Pernambuco, Hospital Correia Picanço, Recife, Pernambuco, Brazil.Universidade Federal de Pernambuco, Programa de Pós Graduação em Medicina Tropical, Recife, Pernambuco, Brazil. Universidade Federal de Pernambuco, Departamento de Medicina Clínica, Recife, Pernambuco, Brazil.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32578726

Citation

Lima, Elaine Cristina Bomfim de, et al. "Chikungunya Encephalitis: Report of a Fatal Case in Northeastern Brazil." Revista Do Instituto De Medicina Tropical De Sao Paulo, vol. 62, 2020, pp. e40.
Lima ECB, Januário AMS, Fortuna EG, et al. Chikungunya encephalitis: report of a fatal case in Northeastern Brazil. Rev Inst Med Trop Sao Paulo. 2020;62:e40.
Lima, E. C. B., Januário, A. M. S., Fortuna, E. G., Real, M. E. C., & Lacerda, H. R. (2020). Chikungunya encephalitis: report of a fatal case in Northeastern Brazil. Revista Do Instituto De Medicina Tropical De Sao Paulo, 62, e40. https://doi.org/10.1590/S1678-9946202062040
Lima ECB, et al. Chikungunya Encephalitis: Report of a Fatal Case in Northeastern Brazil. Rev Inst Med Trop Sao Paulo. 2020;62:e40. PubMed PMID: 32578726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chikungunya encephalitis: report of a fatal case in Northeastern Brazil. AU - Lima,Elaine Cristina Bomfim de, AU - Januário,Alexandre Medeiros Sampaio, AU - Fortuna,Eliane Guimarães, AU - Real,Maria Eulália Corte, AU - Lacerda,Heloísa Ramos, Y1 - 2020/06/17/ PY - 2020/04/13/received PY - 2020/05/16/accepted PY - 2020/6/25/entrez PY - 2020/6/25/pubmed PY - 2020/6/25/medline SP - e40 EP - e40 JF - Revista do Instituto de Medicina Tropical de Sao Paulo JO - Rev. Inst. Med. Trop. Sao Paulo VL - 62 N2 - Chikungunya, a viral infection that presents with fever, rash and polyarthritis, is usually an acute febrile illness. Uncommon neurological manifestations include meningoencephalitis, encephalitis, myelitis, Guillain-Barre syndrome, myelopathy and neuropathy. During an outbreak of the disease in La Reunion Island, abnormalities were observed in the magnetic resonance imaging (MRI) of patients with encephalitis and acute disseminated encephalomyelitis, showing bilateral, frontoparietal, white matter lesions with restricted diffusion, similar to our case. We report a 57-year-old male patient with comorbidities, admitted with high fever, arthralgia, asthenia, vomiting, psychomotor agitation, behavioral changes and seizures. Cerebrospinal fluid (CSF) values revealed pleocytosis (98 cells/mm3 with 68% lymphocytes and 12% monocytes) and high levels of protein (161 mg%). Brain MRI showed hyperintense lesions in the temporal and frontal lobes and bilaterally in the posterior thalamus. CSF serology was positive for IgM antibodies to Chikungunya virus. Encephalitis due to an acute viral infection by Chikungunya was diagnosed. The patient's clinical condition worsened and he died on the twenty-fourth day of admission to our hospital. SN - 1678-9946 UR - https://www.unboundmedicine.com/medline/citation/32578726/Chikungunya_encephalitis:_report_of_a_fatal_case_in_Northeastern_Brazil L2 - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652020000100508&lng=en&nrm=iso&tlng=en DB - PRIME DP - Unbound Medicine ER -
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