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Case Report

Post–Chikungunya Virus Infection Musculoskeletal Disorders: Syndromic Sequelae after an Outbreak

1
Mahidol-Osaka Center for Infectious Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, Japan
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Bangkok Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Point of Care Testing Products Business Unit, TANAKA Kikinzoku Kogyo, Hiratsuka 254-0076, Japan
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Tropical Medicine Diagnostic Reference Laboratory, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
*
Author to whom correspondence should be addressed.
Academic Editor: John Frean
Trop. Med. Infect. Dis. 2021, 6(2), 52; https://doi.org/10.3390/tropicalmed6020052
Received: 26 March 2021 / Revised: 5 April 2021 / Accepted: 13 April 2021 / Published: 15 April 2021
The Chikungunya virus is a re-emerging mosquito-borne alphavirus. Outbreaks are unpredictable and explosive in nature. Fever, arthralgia, and rash are common symptoms during the acute phase. Diagnostic tests are required to differentiate chikungunya virus from other co-circulating arboviruses, as symptoms can overlap, causing a dilemma for clinicians. Arthritis is observed during the sub-acute and chronic phases, which can flare up, resulting in increased morbidity that adversely affects the activities of daily living. During the 2019 chikungunya epidemic in Thailand, cases surged in Bangkok in the last quarter of the year. Here, we demonstrate the chronic sequelae of post-chikungunya arthritis in one of our patients one year after the initial infection. An inflammatory process involving edema, erythema, and tenderness to palpation of her fingers’ flexor surfaces was observed, with positive chikungunya IgG and negative IgM tests and antigen. The condition produced stiffness in the patient’s fingers and limited their range of motion, adversely affecting daily living activities. Resolution of symptoms was observed with a short course of an anti-inflammatory agent. More research is required to determine whether sanctuaries enable chikungunya virus to evade the host immune response and remain latent, flaring up months later and triggering an inflammatory response that causes post-chikungunya arthritis. View Full-Text
Keywords: acute febrile illness; Alphavirus; chikungunya virus; post-chikungunya musculoskeletal disorder; post-chikungunya chronic inflammatory rheumatism acute febrile illness; Alphavirus; chikungunya virus; post-chikungunya musculoskeletal disorder; post-chikungunya chronic inflammatory rheumatism
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MDPI and ACS Style

Imad, H.A.; Matsee, W.; Kludkleeb, S.; Asawapaithulsert, P.; Phadungsombat, J.; Nakayama, E.E.; Suzuki, K.; Leaungwutiwong, P.; Piyaphanee, W.; Phumratanaprapin, W.; Shioda, T. Post–Chikungunya Virus Infection Musculoskeletal Disorders: Syndromic Sequelae after an Outbreak. Trop. Med. Infect. Dis. 2021, 6, 52. https://doi.org/10.3390/tropicalmed6020052

AMA Style

Imad HA, Matsee W, Kludkleeb S, Asawapaithulsert P, Phadungsombat J, Nakayama EE, Suzuki K, Leaungwutiwong P, Piyaphanee W, Phumratanaprapin W, Shioda T. Post–Chikungunya Virus Infection Musculoskeletal Disorders: Syndromic Sequelae after an Outbreak. Tropical Medicine and Infectious Disease. 2021; 6(2):52. https://doi.org/10.3390/tropicalmed6020052

Chicago/Turabian Style

Imad, Hisham A., Wasin Matsee, Sajikapon Kludkleeb, Punyisa Asawapaithulsert, Juthamas Phadungsombat, Emi E. Nakayama, Keita Suzuki, Pornsawan Leaungwutiwong, Watcharapong Piyaphanee, Weerapong Phumratanaprapin, and Tatsuo Shioda. 2021. "Post–Chikungunya Virus Infection Musculoskeletal Disorders: Syndromic Sequelae after an Outbreak" Tropical Medicine and Infectious Disease 6, no. 2: 52. https://doi.org/10.3390/tropicalmed6020052

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