Chikungunya fever presenting as polymyositis complicating into rhabdomyolysis: A case report of rare presentation

Chikungunya is an infection of tropical and sub-tropical areas and is widely prevalent in Indian sub-continent. It typically presents with fever, arthralgia, myalgia, and rash, and may have various complications and atypical presentations of neuro-musculoskeletal origin. Musculoskeletal complications mainly reported are chronic arthritis, enthesitis, and bursitis, with primarily involvement of sites in and around joints from where it has derived its name as “Break-bone Fever.” Weakness or difficulty in walking is usually attributed to these manifestations. We report a rare case of acute chikungunya-induced inflammatory polymyositis successfully managed with corticosteroids. This is a rare and underreported presentation. The case highlights the need for heightened clinical vigilance for atypical presentations of chikungunya, particularly in endemic areas in the acute phase of illness. Knowledge of clinicians to its possibility, early and timely recognition, and timely intervention are critical to favorable outcomes. Very few cases of polymyositis as a presentation of acute phase Chikungunya fever have been reported in the literature from Indian sub-continent. To the best of our knowledge, this may be the first case in Indian subcontinent presenting in the acute phase of Chikungunya infection, underscoring the importance of clinician awareness of this rare presentation in the early phase of illness.