Abstract
We report clinical features and histopathological findings in fatal cases with dengue (DENV) and chikungunya (CHIKV) co-infection identified at the Colombian National Institute of Health between September 2014 and October 2015. Seven such cases were documented. Dengue serotype 2 virus was identified in six cases. All patients were adults and comorbidities were present in four. Fever, arthralgia or myalgia was present in all cases. The frequency of rash, haemorrhage, oedema, and gastrointestinal symptoms was variable. Laboratory findings such as thrombocytopenia, renal failure, and leukocyte count were also inconsistent between cases. Post-mortem tissue examination documented focal hepatocellular coagulative necrosis in three cases, incipient acute pericarditis in one and tubulointerstitial nephritis in one. This study provides evidence of mortality in patients with DENV and CHIKV co-infection. Fatal cases were characterised by variable clinical and laboratory features. Evaluation of histopathology of autopsy tissues provided evidence of the pathological consequences of the disease.
Highlights
Arboviral diseases such as dengue and chikungunya infection are among the leading infectious health problems in the world today [1,2]
Seven fatal cases of dengue virus (DENV) and chikungunya virus (CHIKV) co-infection were identified among 58 CHIKV deaths documented by the National Institute of Health
Clinical features were reported for all cases, but in one patient, laboratory findings were not available (Table)
Summary
Arboviral diseases such as dengue and chikungunya infection are among the leading infectious health problems in the world today [1,2]. The majority of dengue virus (DENV) infections occur in Asia, the Pacific, South and Central America and the Caribbean, where they are considered a public health problem [3]. The chikungunya virus (CHIKV) was first isolated in Tanzania in 1953 and has repeatedly been identified in western, central and southern Africa and in many parts of Asia. Imported cases among tourists have been identified in several European countries and the United States [4]. CHIKV has spread to 33 countries and territories in the Caribbean, South, Central and North America with nearly 2 million cases identified [6]
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