ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Clinical Characteristics, Histopathology, and Tissue Immunolocalization of Chikungunya Virus Antigen in Fatal Cases.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.
- Pooled it
- Research progress on the association between viruses and cardiac diseases.Journal of virology · 2026Review
- Pathogens of the human central nervous system-the major viral pathogens.Journal of neurovirology · 2026Review
- Clinical characteristics and mortality of critically ill patients with chikungunya infection: a multicenter study in Paraguay.BMC infectious diseases · 2026Observational
- GM-CSF and M-CSF Driven Differentiation Differentially Regulates Chikungunya Virus Infection and Antiviral Responses in Human Monocyte-Derived Macrophages.bioRxiv : the preprint server for biology · 2026Article
- Chikungunya viral load in cerebrospinal fluid and blood is not associated with severity of neurological manifestations in children.PLoS neglected tropical diseases · 2026Observational
- Article
- Clinical Features and Factors Associated with Disease Severity in Acute Chikungunya Fever: A Retrospective Analysis.Infection and drug resistance · 2026Article
- Chikungunya Virus in 2025: Epidemiology, Immunopathogenesis, and Vaccine Development - A Narrative Review.Infection and drug resistance · 2026Review
- Hidden in Plain Sight: Alphavirus Persistence and Its Potential for Driving Chronic Pathogenesis.Viruses · 2025Review
- Chikungunya virus replicates in the human testisEmerging microbes & infections · 2025Article
- A Review of the Biology of Chikungunya Virus Highlighting the Development of Current Novel Therapeutic and Prevention Approaches.Pathogens (Basel, Switzerland) · 2025Review
- Global emergence of the chikungunya epidemic: A narrative review of the virus-kidney relationship in Pakistan and beyond.World journal of nephrology · 2025Review
- Chikungunya virus and other emerging arthritogenic alphaviruses.Nature reviews. Microbiology · 2025Review
- Cost-effectiveness of chikungunya vaccination with the live attenuated vaccine in U.S. territories.NPJ vaccines · 2025Article
- Proteomic Analysis of CHIKV-nsP3 Host Interactions in Liver Cells Identifies Novel Interacting Partners.International journal of molecular sciences · 2025Article
- Heterozygous interferon signaling deficient mice as animal models for Chikungunya virus infection in the heart.Scientific reports · 2025Article
- Differential restriction of chikungunya virus in primary human cardiac endothelial cells occurs at multiple steps in the viral life cycle.PLoS neglected tropical diseases · 2025Article
- Review
- Chikungunya Virus: Unveiling Its Global Impact (2002-2024).Interdisciplinary perspectives on infectious diseases · 2025Review
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundDeath in patients with chikungunya is rare and has been associated with encephalitis, hemorrhage, and septic shock. We describe clinical, histologic, and immunohistochemical findings in individuals who died following chikungunya virus (CHIKV) infection.
methodsWe identified individuals who died in Puerto Rico during 2014 following an acute illness and had CHIKV RNA detected by reverse transcriptase-polymerase chain reaction in a pre- or postmortem blood or tissue specimen. We performed histopathology and immunohistochemistry (IHC) for CHIKV antigen on tissue specimens and collected medical data via record review and family interviews.
resultsThirty CHIKV-infected fatal cases were identified (0.8/100 000 population). The median age was 61 years (range: 6 days-86 years), and 19 (63%) were male. Death occurred a median of 4 days (range: 1-29) after illness onset. Nearly all (93%) had at least 1 comorbidity, most frequently hypertension, diabetes, or obesity. Nine had severe comorbidities (eg, chronic heart or kidney disease, sickle cell anemia) or coinfection (eg, leptospirosis). Among 24 fatal cases with tissue specimens, 11 (46%) were positive by IHC. CHIKV antigen was most frequently detected in mesenchymal tissues and mononuclear cells including tissue macrophages, blood mononuclear cells, splenic follicular dendritic cells, and Kupffer cells. Common histopathologic findings were intra-alveolar hemorrhage and edema in the lung, chronic or acute tenosynovitis, and increased immunoblasts in the spleen. CHIKV infection likely caused fatal septic shock in 2 patients.
conclusionsEvaluation of tissue specimens provided insights into the pathogenesis of CHIKV, which may rarely result in septic shock and other severe manifestations.
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