This 22-year-old man, who lived in a region of India where Chikungunya viral infection has been widespread, developed a high fever, head ache, and severe joint pain in association with a morbilliform eruption.
Chickungunya immunoglobulin M antivody test was positive a few days later. Chikungunua is caused by an alphavirus in the Togaviridae family which is transmitted by bites from Aedes aegypti mosquitoes, although other mosquitoes have also been implicated as vectors. Infected individuals develop symptoms including high fever, petechial or morbilliform skin eruption on the extremities and trunk, and severe arthritis which can be debilitating. Occasionally conjunctival injection and photophobia also develop. Fever ltypically asts for 2 days, while other acute symptoms resolve over 5-7 days. Arthritis may persist for several months particularly in older individuals.
symmetric discrete and confluent red macules and papules