Chikungunya infection complicated by encephalitis and rhabdomyolysis

Abstract

Chikungunya virus (CHIKV) typically causes febrile illness and arthralgia. However, severe complications such as encephalitis, rhabdomyolysis, and multiorgan dysfunction are increasingly recognised, particularly during epidemics in endemic regions. We report a case of a 61-year old male presenting with progressive flaccid paraparesis and respiratory failure following febrile illness. Magnetic resonance imaging (MRI) revealed white matter hyperintense foci with restricted diffusion in the periventricular, deep white matter, cerebellum, and middle cerebellar peduncles, consistent with encephalitis. Laboratory findings indicated rhabdomyolysis and acute kidney injury. Serological confirmation of CHIKV highlighted the diagnosis of CHIKV encephalitis complicated by rhabdomyolysis. Despite intensive care, the patient succumbed to refractory shock and hyperkalaemia. This case underscores the importance of early recognition of atypical manifestations of CHIKV, particularly MRI findings, to facilitate timely diagnosis and multidisciplinary management in severe cases.