A Child with Serious Chikungunya Virus (CHIKV) Infection Requiring Intensive Care, After an Outbreak

A 5 1/2-yr-old boy presented with high grade fever for 4 days, and cervical adenitis, body ache, arthralgia, followed by sudden onset of breathlessness. He had clinical, electrocardiographic and echo evidence of myocarditis and congestive cardiac failure. An enzyme-linked immunosorbent assay (MAC-IgM ELISA) with serum collected 5 days after disease onset showed IgM antibodies to CHIKV. He was managed conservatively and started showing symptomatic improvement by 3 days. At discharge, a repeat Echocardiogram (a week later) showed normal left ventricular (LV) function with mild Mitral regurgitation. On follow up, after 2 months, child remains asymptomatic. Other common aetiological agents were screened for and found negative. This may indicate a probable cardiac tropism for the virus.