Chikungunya virus - associated meningitis with transient encephalopathy: a case report.

Background

Chikungunya virus (CHIKV) typically causes acute fever, arthralgia, and rash; central nervous system involvement is rare, and early diagnosis is challenging due to nonspecific presentations. CASE PRESENTATION We report a case of a 37-year-old previously healthy male who presented with fever, confusion, and syncope during a local chikungunya fever outbreak in his city. Neurological examination revealed positive meningeal signs, and his Glasgow Coma Scale score was 14. Targeted next-generation sequencing (tNGS) detected chikungunya virus (CHIKV) in both blood and cerebrospinal fluid. Following supportive care, the patient made a full recovery and remained well at the six-month follow-up, with a favorable prognosis.

Conclusions

In our case, tNGS detected CSF CHIKV RNA after negative mNGS, suggesting possible added value of targeted enrichment in selected settings that requires validation in larger studies.