The patient is in her early 30s and sought medical care in Missouri after recently traveling to Haiti for a one-week missionary trip. Three days after returning, she had a fever, myalgia, and arthralgia. Tests for dengue and chikungunya virus were performed, and she was positive for dengue IgG and negative for dengue IgM antibodies. Both IgM and IgG antibody tests were negative for the chikungunya virus. The patient was diagnosed with dengue fever and placed on bed rest with acetaminophen.
After 3 weeks, the patient still had joint pain in her hands and feet. Repeat laboratory tests for dengue and chikungunya were performed. This time, tests were positive for chikungunya IgM and IgG antibodies, while Dengue IgM and IgG antibodies were negative. She was referred to a rheumatologist for pain management.
This case points out the difficulty in diagnosing both chikungunya and dengue infections.
