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. 2022 Jun 13;107(2):291-295.
doi: 10.4269/ajtmh.22-0050. Print 2022 Aug 17.

Neurological Disease Associated with Chikungunya in Indonesia

Khin S A Myint  1 , Arthur H P Mawuntu  2 , Sotianingsih Haryanto  3   4 , Darma Imran  5 , Sofiati Dian  6 , Yora P Dewi  1 , Ahmad R Ganiem  6 , Riane Anggreani  2 , Mirna M Iskandar  3   4 , Janno B B Bernadus  2 , Kartika Maharani  5 , David Susanto  2 , Riwanti Estiasari  5 , Hasna Dewi  4 , Amanda Kristiani  7 , Lidia Gaghiwu  2 , Edison Johar  1 , Frilasita A Yudhaputri  1 , Ungke Antonjaya  1   8 , Jeremy P Ledermann  9 , Reinout van Crevel  10 , Raph L Hamers  8   11 , Ann M Powers  9
Affiliations

Neurological Disease Associated with Chikungunya in Indonesia

Khin S A Myint et al. Am J Trop Med Hyg. .

Abstract

Chikungunya virus (CHIKV) is recognized but rarely considered as a cause of central nervous system infection in endemic areas. A total of 244 patients with acute meningoencephalitis in Indonesia were retrospectively tested to identify whether any CHIKV infection was associated with neurological manifestations, especially in provinces known for CHIKV endemicity. Cerebrospinal fluid (CSF) and blood specimens were tested using CHIKV-specific real-time reverse transcription polymerase chain reaction and IgM ELISA, alongside a panel of neurotropic viruses. We report four cases of suspected or confirmed CHIKV-associated neurological disease, including CHIKV RNA detection in CSF of one patient and in acute serum of another, and CHIKV IgM in CSF of three patients and in serum of a fourth. In conclusion, CHIKV should be considered as a cause of neurologic disease in endemic areas and especially during outbreaks, in addition to the more common arboviral diseases such as dengue and Japanese encephalitis viruses.

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Figures

Figure 1.
Figure 1.
Computed tomography scan of case 2. Axial non contrast-enhanced computed tomography (CT) scan showed diffuse cerebral edema and subdural hyperdensity in the left frontotemporal region (arrow).
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