Fatal Human Case of Zika and Chikungunya Virus Co-Infection with Prolonged Viremia and Viruria
Zika virus (ZIKV) infection usually presents as a mild and self-limited illness, but it may be associated with severe outcomes. We describe a case of a 30-year-old man with systemic erythematous lupus and common variable immunodeficiency who became infected with both Zika (ZIKV) and Chikungunya (CHI...
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MDPI AG
2018-06-01
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| Series: | Diseases |
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| Online Access: | http://www.mdpi.com/2079-9721/6/3/53 |
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| author | Kelly R. Silva Blanca E. R. G. Bica Eduardo S. Pimenta Rodrigo B. Serafim Mirhelen M. Abreu Jorge L. S. Gonçalves Larissa de S. Santana Mauro J. Cabral-Castro José M. Peralta Marta G. Cavalcanti |
| author_facet | Kelly R. Silva Blanca E. R. G. Bica Eduardo S. Pimenta Rodrigo B. Serafim Mirhelen M. Abreu Jorge L. S. Gonçalves Larissa de S. Santana Mauro J. Cabral-Castro José M. Peralta Marta G. Cavalcanti |
| author_sort | Kelly R. Silva |
| collection | DOAJ |
| description | Zika virus (ZIKV) infection usually presents as a mild and self-limited illness, but it may be associated with severe outcomes. We describe a case of a 30-year-old man with systemic erythematous lupus and common variable immunodeficiency who became infected with both Zika (ZIKV) and Chikungunya (CHIKV) virus during the 2016 outbreak in Rio de Janeiro, Brazil. The patient presented with intense wrist and right ankle arthritis, and ZIKV RNA and virus particles were detected in synovial tissue, blood and urine, and CHIKV RNA in serum sample, at the time of the diagnosis. During the follow up, ZIKV RNA persisted for 275 days post symptoms onset. The patient evolved with severe arthralgia/arthritis and progressive deterioration of renal function. Fatal outcome occurred after 310 days post ZIKV and CHIKV co-infection onset. The results show the development of severe disease and fatal outcome of ZIKV infection in an immunosuppressed adult. The data suggests a correlation between immunodeficiency and prolonged ZIKV RNA shedding in both blood and urine with progressive disease. The results also indicate a possible role for arbovirus co-infections as risk factors for severe and fatal outcomes from ZIKV infection. |
| first_indexed | 2024-12-12T17:44:02Z |
| format | Article |
| id | doaj.art-461475c0d6734d7d9f43d6ecd80b4fd9 |
| institution | Directory Open Access Journal |
| issn | 2079-9721 |
| language | English |
| last_indexed | 2024-12-12T17:44:02Z |
| publishDate | 2018-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diseases |
| spelling | doaj.art-461475c0d6734d7d9f43d6ecd80b4fd92022-12-22T00:16:58ZengMDPI AGDiseases2079-97212018-06-01635310.3390/diseases6030053diseases6030053Fatal Human Case of Zika and Chikungunya Virus Co-Infection with Prolonged Viremia and ViruriaKelly R. Silva0Blanca E. R. G. Bica1Eduardo S. Pimenta2Rodrigo B. Serafim3Mirhelen M. Abreu4Jorge L. S. Gonçalves5Larissa de S. Santana6Mauro J. Cabral-Castro7José M. Peralta8Marta G. Cavalcanti9Serviço de Reumatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (HUCFF/UFRJ), Rio de Janeiro 21941590, BrazilServiço de Reumatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (HUCFF/UFRJ), Rio de Janeiro 21941590, BrazilServiço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (HUCFF/UFRJ), Rio de Janeiro 21941590, BrazilPrograma de Pós Graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (FM/UFRJ), Rio de Janeiro 21941590, BrazilServiço de Reumatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (HUCFF/UFRJ), Rio de Janeiro 21941590, BrazilInstituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro (IMPG/UFRJ), Rio de Janeiro 21941902, BrazilInstituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro (IMPG/UFRJ), Rio de Janeiro 21941902, BrazilPrograma de Pós Graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (FM/UFRJ), Rio de Janeiro 21941590, BrazilPrograma de Pós Graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (FM/UFRJ), Rio de Janeiro 21941590, BrazilServiço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (HUCFF/UFRJ), Rio de Janeiro 21941590, BrazilZika virus (ZIKV) infection usually presents as a mild and self-limited illness, but it may be associated with severe outcomes. We describe a case of a 30-year-old man with systemic erythematous lupus and common variable immunodeficiency who became infected with both Zika (ZIKV) and Chikungunya (CHIKV) virus during the 2016 outbreak in Rio de Janeiro, Brazil. The patient presented with intense wrist and right ankle arthritis, and ZIKV RNA and virus particles were detected in synovial tissue, blood and urine, and CHIKV RNA in serum sample, at the time of the diagnosis. During the follow up, ZIKV RNA persisted for 275 days post symptoms onset. The patient evolved with severe arthralgia/arthritis and progressive deterioration of renal function. Fatal outcome occurred after 310 days post ZIKV and CHIKV co-infection onset. The results show the development of severe disease and fatal outcome of ZIKV infection in an immunosuppressed adult. The data suggests a correlation between immunodeficiency and prolonged ZIKV RNA shedding in both blood and urine with progressive disease. The results also indicate a possible role for arbovirus co-infections as risk factors for severe and fatal outcomes from ZIKV infection.http://www.mdpi.com/2079-9721/6/3/53Zika virusChikungunya virusco-infectionsystemic lupus erythematosus |
| spellingShingle | Kelly R. Silva Blanca E. R. G. Bica Eduardo S. Pimenta Rodrigo B. Serafim Mirhelen M. Abreu Jorge L. S. Gonçalves Larissa de S. Santana Mauro J. Cabral-Castro José M. Peralta Marta G. Cavalcanti Fatal Human Case of Zika and Chikungunya Virus Co-Infection with Prolonged Viremia and Viruria Diseases Zika virus Chikungunya virus co-infection systemic lupus erythematosus |
| title | Fatal Human Case of Zika and Chikungunya Virus Co-Infection with Prolonged Viremia and Viruria |
| title_full | Fatal Human Case of Zika and Chikungunya Virus Co-Infection with Prolonged Viremia and Viruria |
| title_fullStr | Fatal Human Case of Zika and Chikungunya Virus Co-Infection with Prolonged Viremia and Viruria |
| title_full_unstemmed | Fatal Human Case of Zika and Chikungunya Virus Co-Infection with Prolonged Viremia and Viruria |
| title_short | Fatal Human Case of Zika and Chikungunya Virus Co-Infection with Prolonged Viremia and Viruria |
| title_sort | fatal human case of zika and chikungunya virus co infection with prolonged viremia and viruria |
| topic | Zika virus Chikungunya virus co-infection systemic lupus erythematosus |
| url | http://www.mdpi.com/2079-9721/6/3/53 |
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