A Case of Chikungunya with Multi-Organ Involvement - Could it be ‘Expanded Chikungunya Syndrome?’

Abstract

Chikungunya fever is an arboviral disease that commonly presents with sudden fever, rash and arthralgia or arthritis. It is generally self-limiting, while the fever is gone chronic musculoskeletal symptoms may persist for a long time. However, multi-organ involvement remains uncommon and poorly described. We report the case of a 30-year-old man who developed high-grade fever, arthritis, skin rashes and marked weakness. Laboratory investigations revealed leukopenia, thrombocytopenia, markedly elevated hepatic transaminases, and renal impairment with proteinuria and hematuria. Serological tests for dengue were negative whereas chikungunya IgM was positive. This case demonstrates how chikungunya fever though usually known for fever and joint pain, may sometimes significantly involve organs like the liver, kidneys and skin. As with time disease evolves we may be witnessing multi-system chikungunya that can be potentially labeled as expanded chikungunya syndrome.