Arthritis und Fieber aus Mauritius

dInterdisziplinare Notfallstation Summary Arthritis and fever from Mauritius We report the case of a 72-year-old woman admitted to our hospital with fever (39.5 °C), severe joint pains, swelling of the fingers and ankles and a mild rash on abdomen and back. She had returned two days previously from a 15-day stay in Mauritius, and her symptoms had begun during the flight home. She reported sustaining several mosquito bites during her holiday. Laboratory tests showed a normal white blood cell count with a left-shift of 73%, slight thrombocytopenia (145 x 10 9 /L) and elevated CRP (122 mg/L). One day after admission the patient developed leukopenia (1.5 x 10 9 /L) and neutropenia (0.8 x 10 9 /L). Four days after admission the fever had resolved while the joint pains persisted. The suspected diagnosis of chikungunya fever was confirmed by alpha-virus PCR and positive IgM against chikungunya virus. In view of the widespread ongoing epidemics at popular tourist destinations in the Indian Ocean, more imported cases of chikungunya fever are to be expected. Severe arthralgia and arthritis can be useful clues in differentiating chikungunya from dengue virus infection.