Case Report

Recurrent Arthralgias in a Patient With Previous Mayaro Fever Infection

Authors: Shawn F. Taylor, MD, Paresh R. Patel, MD, Thomas J.S. Herold, MD

Abstract

Mayaro fever is an acute, self-limited, febrile, mosquito-borne viral disease manifested by fever, chills, headache, myalgias, and arthralgias. The virus belongs to the family Togaviridaeand the genus Alphavirus. Five other mosquito-borne viruses have been described as causing a similar dengue-like illness. The virus was first isolated in 1954, and the first epidemics were described in 1955 in Brazil and Bolivia. Other cases have been reported in Suriname, Brazil, Peru, French Guiana, and Trinidad. Up to 10 to 15% of febrile illnesses in endemic areas have been attributed to Mayaro virus. The exact pathogenesis and pathophysiology among humans is unknown. Animal models have demonstrated necrosis of skeletal muscle, periosteum, perichondrial tissues, and evidence of meningitis and encephalitis. All previous cases of Mayaro fever describe a self-limited illness. No reports of recurrent symptoms exist in the literature. This report describes a case of recurrent arthralgias in a military service member presenting to the emergency department.


Key Points


* Mosquito-borne alpha-viruses such as Mayaro fever present as a dengue-like illness with fevers and arthralgias.


* Outbreaks and epidemics of Mayaro fever confirmed by virus isolation or serology testing have been documented in Trinidad, Suriname, Brazil, Bolivia, French Guiana, and Peru.


* This is the first reported case in the literature of chronic or recurrent arthralgias caused by Mayaro fever, but recurrent arthralgias and residual joint symptoms have been reported in two other mosquito-borne alpha-viruses (Ross River and Chikungunya).

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