Clinical and magnetic resonance imaging patterns of extensive Chikungunya virus–associated myelitis

Chikungunya fever is an arbovirus infection transmitted by the same mosquito vector of dengue and Zika virus. Besides high fever, common clinical symptoms include articular pain and general malaise. Neurological involvement is unusual, but some patients may develop peripheral and central nervous sys...

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Bibliographic Details
Published in:Journal of neurovirology 2021-08, Vol.27 (4), p.616-625
Main Authors: Rueda-Lopes, Fernanda Cristina, da Cruz, Luiz Celso Hygino, Fontes, Fabrícia Lima, Herlinger, Alice Laschuk, da Costa Ferreira Junior, Orlando, de Aguiar, Renato Santana, Vasconcelos, Claudia Cristina Ferreira, do Nascimento, Osvaldo José Moreira, Alves-Leon, Soniza Vieira
Format: Article
Language:English
Subjects:
Aged
Biomedical and Life Sciences
Biomedicine
Chikungunya Fever - complications
Female
Humans
Immunology
Infectious Diseases
Magnetic Resonance Imaging
Male
Middle Aged
Myelitis - diagnostic imaging
Myelitis - pathology
Myelitis - virology
Neurology
Neurosciences
Short Communication
Virology
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Summary:Chikungunya fever is an arbovirus infection transmitted by the same mosquito vector of dengue and Zika virus. Besides high fever, common clinical symptoms include articular pain and general malaise. Neurological involvement is unusual, but some patients may develop peripheral and central nervous system involvement, including meningoencephalitis, myelitis, Guillain-Barré syndrome, and acute disseminated encephalomyelitis. We present three cases of Chikungunya fever complicated with extensive myelitis. The spinal cord magnetic resonance imaging (MRI) pattern is characterized by multiple dotted-like and longitudinal hyperintense lesions, with contrast enhancement, mostly distributed in the peripheral regions of the spinal cord. It seems that these lesions are mostly located in the perivascular spaces (PVS), related or not to virus attack. Involvement of brain PVS can also be demonstrated, as shown in two of the cases described. Considering the MRI pattern, extensive spinal cord lesion should include Chikungunya as a differential diagnosis, especially during an outbreak.
ISSN:1355-0284
1538-2443
DOI:10.1007/s13365-021-00962-4