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Clinical and magnetic resonance imaging patterns of extensive Chikungunya virus-associated myelitis

Fernanda Cristina Rueda-Lopes1, Luiz Celso Hygino da Cruz2, Fabrícia Lima Fontes3

  • 1Radiology Department of Fluminense Federal University (UFF), DASA (Diagnósticos da América), Avenida Roberto Silveira, 349/1904, Icaraí, Niteroi, Brazil. frueda81@hotmail.com.

Journal of Neurovirology
|July 6, 2021
PubMed

Insights

Chikungunya fever can cause unusual neurological complications, including extensive myelitis affecting the spinal cord. Recognizing specific MRI patterns is crucial for diagnosing this arbovirus infection, especially during outbreaks.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Chikungunya fever is an arbovirus infection spread by mosquitoes, typically causing fever and joint pain.
  • Neurological complications are rare but can be severe, affecting both the central and peripheral nervous systems.

Observation:

  • This study details three cases of Chikungunya fever complicated by extensive myelitis.
  • Spinal cord MRI revealed multiple, dotted, and longitudinal hyperintense lesions with contrast enhancement, primarily in peripheral spinal cord regions.

Findings:

  • Lesions appeared to be located within perivascular spaces (PVS), potentially related to the viral infection.
  • Brain PVS involvement was also observed in two of the presented cases.

Implications:

  • The characteristic MRI findings suggest Chikungunya virus infection should be considered in the differential diagnosis of extensive spinal cord lesions.
  • Early diagnosis is critical, particularly during Chikungunya outbreaks, to guide appropriate patient management and treatment strategies.
Keywords:
ChikungunyaMyelitisNeurological complications

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