Abstract

BackgroundAlthough Chikungunya virus has rapidly expanded to several countries in sub-Saharan Africa, little attention has been paid to its control and management. Until recently, Chikungunya has been regarded as a benign and self-limiting disease. In this report we describe the first case of severe Chikungunya disease in an adult patient in Pemba, Mozambique.Case presentationA previously healthy 40 year old male of Makonde ethnicity with no known past medical history and resident in Pemba for the past 11 years presented with a severe febrile illness. Despite administration of broad spectrum intravenous antibiotics the patient rapidly deteriorated and became comatose while developing anaemia, thrombocytopenia and later, melaena. Laboratory testing revealed IgM antibodies against Chikungunya virus. Malaria tests were consistently negative.ConclusionsThis report suggests that Chikungunya might cause unsuspected severe disease in febrile patients in Mozambique and provides insights for the improvement of national protocols for management of febrile patients in Mozambique. We recommend that clinicians should consider Chikungunya in the differential diagnosis of febrile illness in locations where Aedes aegypti mosquitos are abundant.

Highlights

  • Chikungunya virus has rapidly expanded to several countries in sub-Saharan Africa, little attention has been paid to its control and management

  • This report suggests that Chikungunya might cause unsuspected severe disease in febrile patients in Mozambique and provides insights for the improvement of national protocols for management of febrile patients in Mozambique

  • We recommend that clinicians should consider Chikungunya in the differential diagnosis of febrile illness in locations where Aedes aegypti mosquitos are abundant

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Summary

Conclusions

This report suggests that CHIKV may cause unsuspected severe disease in febrile patients in Mozambique. Most likely, these cases are misdiagnosed and treated with anti-malarial drugs or antibiotics. These cases are misdiagnosed and treated with anti-malarial drugs or antibiotics This case report provides insights for the improvement of national protocols for management of febrile patients in Mozambique and we recommend that clinicians should consider CHIKV in the differential diagnosis of febrile illness in locations where A. aegypti mosquito is abundant. KF, and JC participated in the data analysis, and writing of the manuscript. Author details 1 Pemba Operational Research Unit, Ministry of Health, Pemba, Mozambique. 9 Community Health Department, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

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