Chikungunya Myeloradiculopathy: A Rare Complication
A 56-year-old male patient came with the complaints of inability to walk without support and past H/O fever 20 days back which lasted for 10 days and was associated with the multiple joint pain, swelling and restriction of movements. The joint pain persisted for 2 weeks along with the fever. He was a smoker and occasional alcoholic. There was no other positive history or symptoms pertaining to other system.\nO/E wrist and ankle skin excoriation were present. CNS examination revealed loss of abdominal reflexes, decreased power (3/5) in upper and lower limbs, decreased pain and temperature sensations in bilateral deltoid, neck, and abdominal regions. Considerably, proximal muscle weakness was more than distal muscle weakness.\nIt was diagnosed as post viral arthritis with CNS involvement and hence further evaluated. Laboratory analyses for all parameters were normal except elevated ESR. Serological studies were positive for CRP and Chikungunya IgM ELISA (Done at KING INSTITUTE, Chennai) when all the other tests like RA Factor, ANA, DSDNA, Dengue IgM ELISA, leptospirosis IgM and JE IgM ELISA were negative. CSF analysis showed 95 lymphocytes, protein 83 g/dl, glucose 50 mg/dl and negative results for gram positive or negative organisms. MRI spine revealed findings related to demyelination at C2-C3 and T5-T7 levels. The patient was treated with steroids, NSAIDs and given supportive treatment. He improved clinically but, further follow-up was lost.