Clinical and histopathological features of fatal cases with dengue and chikungunya virus co-infection in Colombia, 2014 to 2015.
We report clinical features and histopathological findings in fatal cases with dengue (DENV) and chikungunya (CHIKV) co-infection identified at the Colombian National Institute of Health between September 2014 and October 2015. Seven such cases were documented. Dengue serotype 2 virus was identified in six cases. All patients were adults and comorbidities were present in four. Fever, arthralgia or myalgia was present in all cases. The frequency of rash, haemorrhage, oedema, and gastrointestinal symptoms was variable. Laboratory findings such as thrombocytopenia, renal failure, and leukocyte count were also inconsistent between cases. Post-mortem tissue examination documented focal hepatocellular coagulative necrosis in three cases, incipient acute pericarditis in one and tubulointerstitial nephritis in one. This study provides evidence of mortality in patients with DENV and CHIKV co-infection. Fatal cases were characterised by variable clinical and laboratory features. Evaluation of histopathology of autopsy tissues provided evidence of the pathological consequences of the disease.
Division of Research in Public Health, National Institute of Health of Colombia, Bogota, Colombia.
Marcela
M
Mercado
Jorge
J
Acosta-Reyes
Edgar
E
Parra
Lissethe
L
Pardo
Angélica
A
Rico
Alfonso
A
Campo
Edgar
E
Navarro
Diego
D
Viasus
D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000453:epidemiology / Q000821:virology; D001344:Autopsy; D065632:Chikungunya Fever / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology*; D002646:Chikungunya virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D060085:Coinfection / Q000401:mortality / Q000821:virology; D003105:Colombia / Q000453:epidemiology; D003715:Dengue / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology*; D003716:Dengue Virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D063806:Myalgia / Q000453:epidemiology / Q000821:virology; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D017423:Sequence Analysis, RNA; D065288:Serogroup
chikungunya; co-infection; dengue fever; mortality