Resumo

ROLON, Patricia et al. Acquired Chikungunya in Newborns: a Case Report. Pediatr. (Asunción) [online]. 2015, vol.42, n.1, pp.42-47. ISSN 1683-9803.  https://doi.org/10.18004/ped.2015.abril.42-47.

Introduction: Chikungunya fever is an emerging viral disease. The virus is not transmitted to the fetus when infections occur during pregnancy; the greatest risk of transmission to the newborn occurs when the mother experiences viremia during the intrapartum, when transmission can reach about 49%. Case Report: A 16-day old full-term newborn from Luque, Paraguay, delivered by cesarean section without complications or risk factors for maternal infection, weighing at birth 3620 grams, with an Apgar of 8/9, and discharged at 48 hs of life with no complications consulted on day 13 of life with fever and rash, with the mother reporting 24 hs duration of fever, generalized rash, and transitory irritability, and was hospitalized with a probable diagnosis of late-onset neonatal sepsis, and ampicillin plus cefotaxime initiated; laboratory tests confirmed leukopenia. On day 4 of disease, progressive deterioration was seen with increased hypoactivity, refusal to feed, polypnea, and continued leukopenia and thrombocytopenia.  Antibiotic coverage was broadened and orotracheal intubation was required, with the patient transferred to the neonatal intensive care unit, where hepatomegaly, bilateral pleural effusion, seizure, and moderate pulmonary hypertension were observed. Favorable progression was seen on day 10, planned extubation was successful, and complete reabsorption of efflux, resolved hepatomegaly, and improved white blood cell count were found; however, platelet count was seen to be decreasing. On completing day 7 of antibiotic therapy cultures were negative. On reinvestigation, an epidemiological link was found. with positive serology for Chikungunya IgM, and the patient returned to the first treating hospital with favorable progression, and discharged to home on day 15 of disease in good condition with hematological recovery. Discussion: Our patient appears to have had an atypically severe case of Chikungunya, for which management is supportive for complications.

Palavras-chave : Chikungunya fever; atypical; newborns.

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