title: Zika Virus and Chikungunya Virus CoInfections: A Series of Three Cases from a Single Center in Ecuador.
abstract: Zika virus (ZIKV) and chikungunya virus (CHIKV) cocirculate throughout much of the tropical Western Hemisphere; however, few cases of coinfection with these two pathogens have been reported. Herein, we describe three cases of ZIKV-CHIKV coinfection detected at a single center in Ecuador: a patient who developed symptoms on postoperative day 5 from an orthopedic procedure, a woman who had traveled to Ecuador for fertility treatment, and a woman who was admitted for Guillain-Barré syndrome and had ZIKV and CHIKV detected in serum and cerebrospinal fluid. All cases were diagnosed using a multiplex real-time reverse transcription polymerase chain reaction, and ZIKV viremia was detected as late as 16 days after symptom onset. These cases demonstrate the varied clinical presentation of ZIKV-CHIKV coinfections as well as the importance of multiplexed arboviral testing for these pathogens.
authors.affiliation: Laboratorio de Biología Molecular, Hospital Luis Vernaza, Guayaquil, Ecuador. hzambrano@jbgye.org.ec.
authors.forename: Hector
authors.initials: H
authors.lastname: Zambrano
authors.affiliation: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Waggoner
authors.affiliation: Laboratorio de Biología Molecular, Hospital Luis Vernaza, Guayaquil, Ecuador.
authors.forename: Cristina
authors.initials: C
authors.lastname: Almeida
authors.affiliation: Laboratorio de Biología Molecular, Hospital Luis Vernaza, Guayaquil, Ecuador.
authors.forename: Lisette
authors.initials: L
authors.lastname: Rivera
authors.affiliation: Departamento de Neurología, Hospital Luis Vernaza, Guayaquil, Ecuador.
authors.forename: Juan Quintana
authors.initials: JQ
authors.lastname: Benjamin
authors.affiliation: Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California. Department of Pathology, Stanford University School of Medicine, Stanford, California.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Pinsky
mesh_terms: D000328:Adult; D065632:Chikungunya Fever / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications*; D002646:Chikungunya virus / Q000235:genetics; D060085:Coinfection / Q000821:virology*; D004484:Ecuador; D005260:Female; D005264:Femoral Fractures / Q000601:surgery; D017759:Fractures, Malunited / Q000601:surgery; D020275:Guillain-Barre Syndrome / Q000134:cerebrospinal fluid / Q000821:virology; D006801:Humans; D008297:Male; D057193:Medical Tourism; D008875:Middle Aged; D019637:Orthopedic Procedures; D011183:Postoperative Complications / Q000821:virology; D012367:RNA, Viral / Q000097:blood; D060888:Real-Time Polymerase Chain Reaction; D027724:Reproductive Techniques, Assisted; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014766:Viremia / Q000097:blood / Q000150:complications*; D000071244:Zika Virus / Q000235:genetics; D000071243:Zika Virus Infection / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications*
chemical_list: D012367:RNA, Viral