Chikungunya viral arthritis mimicking seronegative rheumatoid arthritis

Abstract

Chikungunya virus (CHIKV) is an arthritogenic arbovirus infection transmitted through the mosquitoes Aedes aegypti and Aedes albopictus. The clinical picture is diverse-from mildly flowing, almost asymptomatic forms to characteristic episodes of fever, polymyalgia, polyarthralgia, and arthritis. Globalization of the world is increasing the chances of infection spreading outside known endemic areas. This necessitates a broad differential diagnosis, especially in cases that mimic inflammatory joint diseases such as rheumatoid arthritis. The presented clinical case is of a patient who has returned from a trip to the Maldives and Is the first in the Republic of Bulgaria as far as we know, and is established after a detailed literature reference fias been made. Rheumatologists, even in non-CHIKV-endemic regions, should consider CHIKV in their evaluation of symmetric polyarthritis lasting above six weeks, especially in case of anamnesis for a trip to the endemic regions to CHIKV that are likely to expand in the near future. However, demonstrating positive antibodies to the Chikungunya virus is the rheumatologist's primary help in distinguishing the two diseases.