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Case report
Ref Number: APCP-PP-184

Chikungunya-Associated Meningitis in an Infant: A Rare Clinical Presentation

D. Sachini Kaushalya Weerakkody¹, Dilumini Dissanayaka¹, Ann Modaragama², Nadeeka Peris¹, Kapila Panditha¹
1- Lady Ridgeway Hospital for Children, Sri Lanka 2- Colombo North Teaching Hospital, Sri Lanka
Corresponding Author: D. Sachini Kaushalya Weerakkody (sachini.weerakkody@gmail.com)
Abstract Body
Introduction: Chikungunya is an acute viral illness caused by the Chikungunya virus (CHIKV), an RNA virus of the genus Alphavirus in the family Togaviridae, transmitted by Aedes mosquitoes. Although it classically presents with fever, rash, and severe arthralgia, neurological complications are increasingly recognized. These include encephalitis, meningoencephalitis, and, rarely , isolated meningitis. Case: A 3-month-old infant admitted with a two-day history of fever and generalized erythematous rash, associated with irritability and excessive crying. Birth history was unremarkable. On admission, the infant was febrile and looked ill. He had a generalized erythematous, maculopapular, blanching rash. He was hemodynamically stable. Cardiovascular, respiratory , abdominal and neurological examinations were unremarkable. Following admission, the child’s clinical condition deteriorated, progressing to septic shock, necessitating intravenous fluid resuscitation. Investigations: Full blood count WBC- 6.3* 109/L, Hb- 8g/dL, Platelet- 383* 109/L, CRP- 64mg/dL,Blood gas showed metabolic acidosis. Liver and renal functions, electrolytes and coagulation profile were normal. CSF full report- lymphocytes -14 cells/mm3, protein 44 mg/dL with no sugar difference. Blood and CSF cultures were negative. Chikungunya IgM was positive. Ultrasound of the brain and abdomen, and echocardiogram were normal. The child was treated with intravenous antibiotics and a follow-up was arranged. Conclusion: Currently , there is no antiviral treatment for Chikungunya. Management remains supportive and symptomatic. Chikungunya-associated meningitis is an uncommon but potentially serious complication in children and may lead to significant morbidity , underscoring the need for early recognition and prompt management.
Keywords: Chikungunya-associated meningitis; Presentation; Rare
Presentation Type: Case report
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