Chikungunya associated acute necrotizing encephalopathy in an adolescent: Expanding the neurological spectrum of the virus.

Acute necrotizing encephalopathy (ANE) is a rare and severe neurological disorder characterized by rapid onset encephalopathy following a viral febrile illness. A 12-year-old adolescent girl presented with fever, joint pain, and myalgia for 3 days, followed by the development of multiple convulsions and altered sensorium. Cerebrospinal fluid analysis was non-specific. Contrast-enhanced magnetic resonance imaging of the brain revealed two well-defined, bilaterally symmetrical, round-to-oval hyperintense lesions on T2W, and FLAIR sequences, representing acute necrotizing encephalopathy. Polymerase chain reaction (PCR) for Chikungunya virus was positive in cerebrospinal fluid. She was managed with multimodal treatment comprising intravenous methylprednisolone, antiepileptic medications, and other supportive measures according to clinical requirements. To our knowledge, chikungunya-associated acute necrotizing encephalopathy appears to be extremely rare and not well described in the literature. We report an adolescent female with this presentation who showed clinical improvement following multimodal treatment that included corticosteroid therapy.