Chikungunya encephalitis, a case series from an endemic country

BackgroundThe Chikungunya Virus (CHIKV) was introduced into Honduras in 2015. Since then the WHO has reported more than 14,000 suspected cases country. Objective: To describe clinical, laboratory, neuroimaging, and pathological features of CHIKV encephalitis.Patients methodsWe evaluated all consecutive infection meeting encephalitis criteria at Hospital Escuela Universitario Tegucigalpa, Honduras, during Who case definition used: patient with neurological manifestations clinical (fever >38.5 °C, joint pain); resident/visitor last 15 days to an endemic area; laboratory confirmation IgM/ELISA. Other etiologies were excluded by ancillary studies.ResultsOut 95 infection, 7 (7%) identified; mean age 56 years four men. The latency from onset symptoms diagnosis 5 five days. Clinical were: fever/arthralgia, headache/alteration consciousness status epilepticus. EEG demonstrated slow background activity generalized epileptiform discharges three patients. Brain MRI showed bilateral white matter hyperintensities one focal encephalitis; CSF analysis lymphocytic pleocytosis hyperproteinorrachia. Two patients died. Postmortem brain examination revealed infiltrates necrosis hippocampus, frontal lobes medulla oblongata.ConclusionsNeurological complications are infrequent, but may be severe. In this series, manifestation encephalitis. Predominant signs fever, behavioral abnormalities, headache seizures. Because potential morbidity mortality encephalitis, these should admitted hospital urgently.