{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:04:18Z","timestamp":1787169858700,"version":"build-2736575974"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 1","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chikungunya virus (CHIKV) infection is an arboviral disease transmitted by Aedes mosquitoes, typically presenting with fever, rash, and polyarthralgia. Neurological complications such as meningitis are rare and more often seen in neonates and immunocompromised individuals. Hepatic involvement is also uncommon, with only a few reports describing significant hepatitis in the absence of other risk factors. We report the case of a 68-year-old male, previously healthy with no comorbidities, who presented with acute febrile illness followed by severe headache, neck stiffness, and altered sensorium. Laboratory investigations revealed elevated transaminases, and cerebrospinal fluid analysis was consistent with viral meningitis. Serology confirmed CHIKV infection (immunoglobulin M enzyme-linked immunosorbent assay positive). Neuroimaging was unremarkable. The patient was managed with supportive care, intravenous fluids, and close neurological monitoring. Liver function normalized gradually over 2 weeks, and neurological recovery was complete by discharge. This case highlights the rare dual presentation of Chikungunya meningitis and hepatitis in an elderly patient without underlying comorbidities, underscoring the need for clinicians in endemic areas to consider CHIKV in the differential diagnosis of viral meningitis with hepatic dysfunction.<\/jats:p>","DOI":"10.4103\/aam.aam_445_25","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T18:00:12Z","timestamp":1771696812000},"page":"S15-S19","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Epstein\u2013Barr Virus-positive Diffuse Large B-cell Lymphoma Presenting as Pyrexia of Unknown Origin Complicated by Paraneoplastic Neurological Syndrome"],"prefix":"10.4103","volume":"25","author":[{"given":"Govind S.","family":"Shiddapur","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yagnam Sai","family":"Hareeswar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonali","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"R1-20260819","doi-asserted-by":"crossref","first-page":"23","DOI":"10.3960\/jslrt.47.23","article-title":"Spontaneous regression of diffuse large B-cell lymphoma harbouring Epstein-Barr virus: A case report and review of the literature","volume":"47","author":"Abe","year":"2007","journal-title":"J Clin Exp Hematop"},{"key":"R2-20260819","doi-asserted-by":"crossref","first-page":"51","DOI":"10.2169\/internalmedicine.53.0219","article-title":"Epstein-Barr virus-positive diffuse large B-cell lymphoma of the elderly complicated by the onset of acute myeloid leukemia","volume":"53","author":"Kunitomi","year":"2014","journal-title":"Intern Med"},{"key":"R3-20260819","first-page":"4803071","article-title":"EBV positive diffuse large B cell lymphoma with negative pan-B cell markers, case report, and literature review","author":"Shold","year":"2024","journal-title":"Case Rep Hematol 2024"},{"key":"R4-20260819","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s13000-020-00989-x","article-title":"EBV-positive intravascular large B-cell lymphoma of the liver: A case report and literature review","volume":"15","author":"Li","year":"2020","journal-title":"Diagn Pathol"},{"key":"R5-20260819","doi-asserted-by":"crossref","first-page":"488","DOI":"10.32677\/IJCR.2020.v06.i09.003","article-title":"Epstein-Barr virus-positive diffuse large B-cell lymphoma, not otherwise specified: A diagnostic challenge","volume":"6","author":"Aiyer","year":"2020","journal-title":"Indian Journal of Case Reports"},{"key":"R6-20260819","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1002\/iju5.12429","article-title":"Epstein-Barr virus-related diffuse large B-cell lymphoma type methotrexate-associated lymphoproliferative disorders presenting in the adrenal gland","volume":"5","author":"Doi","year":"2022","journal-title":"IJU Case Rep"},{"key":"R7-20260819","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1182\/blood-2016-01-643569","article-title":"The 2016 revision of the World Health Organization classification of lymphoid neoplasms","volume":"127","author":"Swerdlow","year":"2016","journal-title":"Blood"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_445_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:14:10Z","timestamp":1787166850000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_445_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,20]]},"references-count":7,"journal-issue":{"issue":"Suppl 1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_445_25","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,20]]},"assertion":[{"value":"2025-08-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-09","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}