Immune mediated hemolysis after Chikungunya viral infection

This case describes a patient with recent Chikungunya viral infection and developing anemia after international travel to an endemic region. This viral exposure has become more common and occasionally seen in North America. Pertinent findings of the case are described. Post-viral hemolytic anemia was found 9 weeks after exposure in this patient. The patient's anemia persisted for 15 weeks until a full recovery of hemoglobin levels and hemolysis labs occurred. The patient was able to be followed expectantly. Post-viral symptom management generally employs supportive measures for symptomatic patients. Decisions regarding the evaluation and management of the anemia are described. Immune-mediated hemolysis has not been consistently reported in association with prior Chikungunya infection to date. As the incidence of Chikungunya infections has escalated in the last few decades it will be important for clinicians to understand this related post-viral hematologic occurrence with possible comorbidity.