Extra-articular Manifestations of Chikungunya
Jobson Lopes de Oliveira, Igor Albuquerque Nogueira, J. Kennedy Amaral, Luciana Ribeiro Campos, Mariana Macêdo Militão Mendonça, Marília de Brito Ricarte, Luciano Pamplona de Góes Cavalcanti, Robert T. Schoen
Abstract
Chikungunya fever (CHIK) is a neglected tropical disease associated with chronic arthritis. CHIK is usually a self-limiting condition; however, extra-articular manifestations present as atypical illness in a minority of patients. These atypical features may mimic other conditions and potentially distract physicians from the true diagnosis. This review analyzes the evidence of many unusual extra-articular manifestations reported in cases of CHIK. Depending on the affected system, these unusual manifestations include encephalitis, myocarditis, acute interstitial nephritis, cutaneous manifestations, acute anterior uveitis, abdominal pain, and depression. In addition, coinfections and comorbidities may cause atypical illness and obscure the diagnosis. Further studies are required to clarify the pathophysiology and natural history of CHIK, as it remains a burdening condition. Exploring its atypical symptoms may be the missing scientific piece of this puzzle.