Atypical skin manifestation in severe acute chikungunya infection in a pregnant woman: a case report

Figures

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  Fig. 1. Skin manifestations revealed A maculopapular rashes on the forehead B cheeks and nose, as well as C–E multiple small, clear vesicles on an erythematous maculopapular background on the abdomen. A nonhemorrhagic vesicular rash on the lateral side of both thighs with some bullae formation on the ventral side of the upper thighs was also noted. F Numerous discrete, crusting, and coalescing hemorrhagic vesicles on the right thigh were noted

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  Fig. 2. Chest X-ray revealed airspace opacifications with bronchogram presence in the perihilar and lower lung areas bilaterally. No cardiomegaly was demonstrated

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  Fig. 3. Skin biopsy revealed subepidermal vesicles containing acantholytic cells and reepithelization in the epidermis

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  Fig. 4. Phylogenetic analysis of the chikungunya E1 gene from patient samples and comparison with reference strains. The scale bar represents nucleotide substitutions per site. Strains are shown with accession numbers and classified according to country and sampling year. The black dot indicates the strain identified as infecting our patient.