a case of infantile chikungunya

1. CASE 6
• 7 month male baby
• Fever 2 day, febrile seizure- GTCC on day 2 of
fever
• Developmentally normal, primary immunisation
done, thriving well
• Father had h/o febrile seizure during child hood
• Developed facial swelling and lower limb edema
on day 3, along with maculoerythematous rash
both lower limbs

2. • Vitals stable, except tachycardia when fever
• No meningeal signs, no neurodeficit
• CRP- negative, dengue NS1 negative
• Na- 137.4, K-3.95, Cl-99, Sr. Ca- 9.8, Sr. Mg-2.13
• Urine r/m- WNL
• Hemogram- WNL
• ? differentials

4. • Swelling, fever, rash persisted on day 4
• Mother had h/o fever, followed by severe joint
pains
• Mother’s Chikungunya IgM sent- Positive
• We counselled parents it may not come positive
for baby, as its too early, but as parents insisted
we sent- came negative
• Child was treated symptomatically, fever ad
swelling started reducing on day 5, child was
discharged on day 7 when afebrile for 48 hours
• Repeat Chikungunya IgM for baby was sent on
follow-up, which came positive.

6. Discussion for chikungunya
• The natural history of CHIKV is the resolution of acute
symptoms within 7 to 10 days.
• Treatment is primarily symptomatic, with no specific
antiviral therapy recommended.
• Providers should assess hydration and hemodynamic
status and provide supportive care as needed.
• Acetaminophen can be used for fever and pain control
• Compared with adult cases, pediatric patients are more
likely to have a range of acute neurological and
dermatological manifestations, while being less likely
to develop subacute or chronic joint problems