title: [Septic shock secondary to non-congenital chikungunya fever in a young infant: A clinical case].
abstract: A chikungunya outbreak took place in the State of Yucatan starting in the second half of 2015 OBJECTIVE: To analyse the clinical course of a case of chikungunya in a previously healthy infant, providing practical evidence to guide future diagnoses and treatment during outbreak seasons in endemic areas
  
  
  
  Clinical manifestation started with a sudden onset of fever and a diffuse macular-papillary erythema, originally treated in the community with non-steroidal anti-inflammatory drugs. Two days later, the fever relapsed with hypoactivity, severe thrombocytopenia and neutropenia (without lymphopenia), respiratory distress, liver dysfunction, sepsis, followed by septic shock with a fatal outcome. IgM test was positive to chikungunya, while her mother tested negative. Pseudomonas aeruginosa was isolated from the blood culture possible due to contamination, without ruling out the possibility of a mixed origin sepsis.
  
  
  
  Chikungunya is a disease in which the manifestations in neonates and young infants can be severe, and even fatal. It is important to suspect it in this age group at risk of vector contact, in the presence of fever without apparent source of infection and cutaneous manifestations. It is important to use the antipyretics cautiously, considering the possibility of aggravating the underlying infection, and the potential hepatic and haematological damage.
authors.affiliation: Centro de Investigación y de Estudios Avanzados del IPN, Departamento de Ecología Humana, Mérida, Yucatán, México. Electronic address: ninuxka@hotmail.com.
authors.forename: Nina
authors.initials: N
authors.lastname: Méndez-Domínguez
authors.affiliation: Hospital General Dr. Agustín O'Horán, Mérida, Yucatán, México.
authors.forename: Jorge Augusto
authors.initials: JA
authors.lastname: Achach-Asaf
authors.affiliation: Hospital General Dr. Agustín O'Horán, Mérida, Yucatán, México.
authors.forename: Luis Manuel
authors.initials: LM
authors.lastname: Basso-García
authors.affiliation: Hospital General Dr. Agustín O'Horán, Mérida, Yucatán, México.
authors.forename: Yazmín Berenice
authors.initials: YB
authors.lastname: Quiñones-Pacheco
authors.affiliation: Hospital General Dr. Agustín O'Horán, Mérida, Yucatán, México.
authors.forename: Salvador
authors.initials: S
authors.lastname: Gómez-Carro
mesh_terms: D065632:Chikungunya Fever / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D004196:Disease Outbreaks; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000209:etiology* / Q000821:virology; D006801:Humans; D007223:Infant; D008800:Mexico; D012772:Shock, Septic / Q000209:etiology* / Q000821:virology
keywords: Chikungunya; Infant; Lactante; Sepsis; Septic shock; Shock séptico