Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20190035
Brazilian Journal of Pain
Case Report

Orofacial manifestations of chikungunya infection. Case report

Manifestações orofaciais após infecção por vírus da chikungunya. Relato de caso

Ana Paula Varela Brown Martins; Juliana Stugisnki-Barbosa; Paulo Cesar Rodrigues Conti

http://dx.doi.org/10.5935/2595-0118.20190035 BrJP, vol.2, n2, p.204-207, 2019
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Abstract

BACKGROUND AND OBJECTIVES: The chikungunya virus is a human pathogen responsible for a disease characterized by fever, headache, myalgia, skin rash and acute and persistent arthralgia. The purpose of this case report was to describe the orofacial manifestations of a patient infected with the chikungunya virus.

CASE REPORT: A female patient was referred to the Universidade Federal de Juiz de Fora, MG dental clinic due to severe facial pain. Two weeks earlier, she had been diagnosed with chikungunya virus infection by ELISA. After the febrile period and skin rash, the patient presented severe pain in the shoulders, knees, and face, which make it difficult to move and perform daily activities. She was diagnosed with temporomandibular disorders (arthralgia and myofascial pain in the masseter muscle on the right side). The patient was counseled about diet free of pain, hot packs and massages in the painful region. She was already self-medicated with corticosteroids. In addition, she was instructed to seek a specialist for her body pain. The manifestations caused by infection were healed after 10 days of the beginning of the use of corticosteroids and counseling.

CONCLUSION: To date, no reports have been published in the literature about the orofacial manifestation of chikungunya virus, which could serve as a basis to aid in diagnosis temporomandibular joint disorders secondary to chikungunya virus or resulting from possible psychological alteration due to constant generalized pain) and treatment. The detailed anamnesis provided information about a probable temporomandibular joint disorder secondary to Chikungunya virus infection, and it was remarkable as improvement of the systemic factors resulted in the remission of orofacial symptomatology.

Keywords

Chikungunya virus, Facial pain, Temporomandibular joint disorders

Resumo

JUSTIFICATIVA E OBJETIVOS: O vírus chikungunya é um patógeno humano responsável por uma doença caracterizada por febre, dor de cabeça, mialgia, erupção cutânea e artralgia aguda e persistente. O objetivo deste relato de caso foi descrever as manifestações orofaciais de uma paciente infectada pelo vírus chikungunya.

RELATO DO CASO: Paciente do sexo feminino foi encaminhada para a clínica odontológica da Universidade Federal de Juiz de Fora, MG, devido à dor orofacial grave. Duas semanas antes, ela havia sido diagnosticada com infecção por vírus chikungunya. Após período febril e erupção cutânea, a paciente apresentou dor intensa nos ombros, joelhos e face, que dificultava a movimentação e realização das atividades diárias. Foi diagnosticada com desordens temporomandibulares (artralgia e dor miofascial com referência do músculo masseter no lado direito). A paciente foi orientada sobre dieta livre de dor, compressas quentes e massagens na região dolorosa. Ela já se automedicava com corticosteróides. Foi instruída a procurar especialista para suas dores no corpo. As manifestações provocadas pela infecção foram curadas após 10 dias do início do uso de corticosteroides e aconselhamento.

CONCLUSÃO: Até o momento, nenhum relato foi publicado na literatura sobre a manifestação orofacial do vírus chikungunya, que poderia servir de base para auxiliar no diagnóstico de disfunção temporomandibular secundária ao vírus chikungunya ou resultante de possível alteração psicológica por dor generalizada constante) e tratamento. A anamnese detalhada forneceu informações sobre uma provável disfunção temporomandibular secundária à infecção pelo vírus chikungunya e foi notável, pois a melhora dos fatores sistêmicos resultou na remissão do sintoma orofacial.

Palavras-chave

Dor facial, Vírus chikungunya, Transtornos da articulação temporomandibular

References

Haese NN, Broeckel RM, Hawman DW, Heise MT, Morrison TE, Streblow DN. Animal models of Chikungunya virus infection and disease. J Infect Dis. 2016;214(^sSuppl 5):S482-7.

Dhanwani R, Khan M, Lomash V, Rao PV, Ly H, Parida M. Characterization of chikungunya virus induced host response in a mouse model of viral myositis. PLoS One. 2014;9(3).

Schwartz O, Albert ML. Biology and pathogenesis of chikungunya virus. Nat Rev Microbiol. 2010;8(7):491-500.

Dupuis-Maguiraga L, Noret M, Brun S, Le Grand R, Gras G, Roques P. Chikungunya disease infection-associated markers from the acute to the chronic phase o arbovirus-induced arthralgia. PLoS Negl Trop Dis. 2012;6(3).

Gérardin P, Fianu A, Malvy D, Mussard C, Boussaïd K, Rollot O. Perceived morbidity and community burden after a chikungunya outbreak: the TELECHIK survey, a population-based cohort study. BMC Med. 2011;9:5.

Schilte C, Staikowsky F, Couderc T, Madec Y, Carpentier F, Kassab S. Chikungunya virus-associated long-term arthralgia: a 36-month prospective longitudinal study. PLoS Negl Trop Dis. 2013;7(3).

Marimoutou C, Ferraro J, Javelle E, Deparis X, Simon F. Chikungunya infection: self-reported rheumatic morbidity and impaired quality of life persist 6 years later. Clin Microbiol Infect. 2015;21(7):688-93.

Burt FJ, Chen W, Miner JJ, Lenschow DJ, Merits A, Schnettler E. Chikungunya virus: an update on the biology and pathogenesis of this emerging pathogen. Lancet Infect Dis. 2017;17(4):e107-17.

Rulli NE, Rolph MS, Srikiatkhachorn A, Anantapreecha S, Guglielmotti A, Mahalingam S. Protection from arthritis and myositis in a mouse model of acute chikungunya virus disease by bindarit, an inhibitor of monocyte chemotactic protein-1 synthesis. J Infect Dis. 2011;204(7):1026-30.

Borgherini G, Poubeau P, Staikowsky F, Lory M, Le Moullec N, Becquart JP. Outbreak of chikungunya on reunion island: Early clinical and laboratory features in 157 adult patients. Clin Infect Dis. 2007;44(11):1401-7.

Burt FJ, Rolph MS, Rulli NE, Mahalingam S, Heise MT. Chikungunya: a re-emerging virus. Lancet. 2012;379(9816):662-71.

Nakaya HI, Gardner J, Poo YS, Major L, Pulendran B, Suhrbier A. Gene profiling of Chikungunya virus arthritis in a mouse model reveals significant overlap with rheumatoid arthritis. Arthritis Rheum. 2012;64(11):3553-63.

Ozden S, Huerre M, Riviere JP, Coffey LL, Afonso PV, Mouly V. Human muscle satellite cells as targets of chikungunya virus infection. PLoS One. 2007;2(6).

Paquet C, Quatresous I, Solet JL, Sissoko D, Renault P, Pierre V. Chikungunya outbreak in Reunion: epidemiology and surveillance, 2005 to early January 2006. Euro Surveill. 2006;11(2).

de Leeuw R, Klasser GD. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. 2018.

Manimunda SP, Vijayachari P, Uppoor R, Sugunan AP, Singh SS, Rai SK. Clinical progression of chikungunya fever during acute and chronic arthritic stages and the chances in joint morphology as revealed by imaging. Trans R Soc Trop Med Hyg. 2010;104(6):392-9.

Sissoko D, Malvy D, Ezzedine K, Renault P, Moscetti F, Ledrans M. Post-epidemic chikungunya disease on Reunion Island: course of rheumatic manifestations and associated factors over a 15-month period. PLoS Negl Trop Dis. 2009;3(3).

Ramful D, Carbonnier M, Pasquet M, Bouhmani B, Ghazouani J, Noormahomed T. Mother-to-child transmission of Chikungunya virus infection. Pediatr Infect Dis J. 2007;26(9):811-5.

Economopoulou A, Dominguez M, Helynck B, Sissoko D, Wichmann O, Quenel P. Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005-2006 outbreak on Réunion. Epidemiol Infect. 2009;137(4):534-41.

Burt F, Chen W, Mahalingam S. Chikungunya virus and arthritic disease. Lancet Infect Dis. 2014;14(9):789-90.

Ng LF, Chow A, Sun YJ, Kwek DJ, Lim PL, Dimatatac F. IL-1beta, IL-6, and RANTES as biomarkers of Chikungunya severity. PLoS One. 2009;4(1).

Fillingim RB, Ohrbach R, Greenspan JD, Knott C, Diatchenko L, Dubner R. Psychological factors associated with development of TMD: the OPPERA prospective cohort study. J Pain. 2013;14(12 Suppl):T75-90.

Poveda Roda R, Bagan JV, Díaz Fernández JM, Hernández Bazán S, Jiménez Soriano Y. Review of temporomandibular joint pathology. Part I: classification, epidemiology and risk factors. Med Oral Patol Oral Cir Bucal. 2007;12(4):E292-8.

Martins HA, Bernardino SN, Santos CC, Ribas VR. Chikungunya and myositis: a case report in Brazil. J Clin Diagn Res. 2016;10(12):OD05-6.

Carmona RJ, Shaikh S, Khalidi NA. Chikungunya viral polyarthritis. J Rheumatol. 2008;35(5):935-6.

Pialoux G, Gaüzère BA, Jauréguiberry S, Strobel M. Chikungunya, an epidemic arbovirosis. Lancet Infect Dis. 2007;7(5):319-27.

Submitted date:
09/17/2018

Accepted date:
03/21/2019

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