Abstract

Purpose: Ocular involvement in chikungunya fever is uncommon finding. We describe the clinical presentation and management of ocular manifestation in a 60 year old male post chikungunya viral infection.

Observation: 60 years male, normotensive, developed hyperglycemia post chikungunya fever, reported with acute, painless horizontal binocular diplopia mainly in primary gaze and left lateral gaze for distance and near with limitation of abduction in left eye with no neurological deficit. Clinical examination was suggestive of isolated sixth nerve palsy. Chikungunya virus serology was found to be positive.

Conclusion: Delayed Immune mediated reaction to viremia may cause damage to sixth nerve, hence presenting as diplopia months after attack of chikungunya fever. Our case highlights the pathogenesis of chikungunya induced sixth nerve palsy and self-limiting course with good recovery.

Keywords: Sixth Nerve Palsy; Chikungunya Virus Infection

References

1. Robinson MC. “An epidemic of virus disease in Southern Province, Tanganyika Territory, in 1952–53. I. Clinical features”. Transactions of the Royal Society of Tropical Medicine and Hygiene 49 (1955): 28-32.
2. Lumsden WH. “An epidemic of virus disease in Southern Province, Tanganyika Territory, in 1952–53. II. General description and epidemiology”. Transactions of the Royal Society of Tropical Medicine and Hygiene 49 (1955): 33-57.
3. AL Schmaljohn and D McClain. “Medical Microbiology”. 4th edition, Galveston (TX): University of Texas Medical Branch at Galveston (1996).
4. Josseran L., et al. “Chikungunya disease outbreak, Reunion Island”. Emerging Infectious Disease 12 (2006): 1994 -1995.
5. Mahendradas P., et al. “Ocular Manifestations Associated with Chikungunya”. Ophthalmology 115 (2008): 287-291.
6. Mittal A., et al. “Optic Neuritis Associated with Chikungunya Virus Infection in South India”. Archives of Ophthalmology 10 (2007): 1381-1386.
7. Lalitha P., et al. “Ocular involvement associated with an epidemic outbreak of chikungunya virus infection”. American Journal of Ophthalmology 144 (2007): 552-556.
8. Barreto FK., et al. “Chikungunya and diabetes, what do we know?”. Diabetology and Metabolic Syndrome 32 (2018).
9. Benzekri R., et al. “Third Cranial Nerve Palsy in the Setting of Chikungunya Virus Infection”. The American Journal of Tropical Medicine and Hygiene 1 (2016): 180-181.
10. Das T., et al. “Chikungunya fever: CNS infection and pathologies of a re-emerging arbovirus”. Progress in Neurobiology 91 (2010):121-129.

Citation

Citation: Reena Gupta., et al. “Sixth Nerve Palsy Post Chikungunya Virus Infection- A Rare Case". Acta Scientific Microbiology 3.1 (2020): 150-153.

Copyright

Copyright: © 2020 Reena Gupta., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.