• M Sigrid Mac Donald-Ottevanger, Charleen I Gravenberch-Ramnandanlall, and C W R Wilco Zijlmans.
• Academisch Ziekenhuis Paramaribo, Paramaribo, Suriname.
• Ned Tijdschr Geneeskd. 2015 Jan 1;159:A8403.

AbstractChikungunya is a rapidly spreading infectious disease throughout the Caribbean, reaching epidemic proportions in Suriname, with more than 1200 registered cases in 2014. Similar to dengue, classic symptoms are high fever, rash and arthralgia. However, the presentation differs in adults and children. At the Academic Hospital Paramaribo in Suriname, three children had different presentations of chikungunya. An 11-year-old girl was referred to the paediatric centre with acute-onset fever of 40.5ºC, painful knees and a rash on face and arms. Koplik spots were visible on the inside of her mouth. A 13-year-old boy attended the ER with acute-onset fever and a state of reduced consciousness. Physical examination revealed hypotension, tachycardia and fever. No rash was observed. A 2.5-month-old baby with fever, vomiting, diarrhoea and a rash was brought to the ER. She was agitated and had signs of meningism. The symptoms resolved quickly in all patients after rehydration and pain medication.

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