Atypical Presentation of Chikungunya in a 64-Year-Old Man: A Case Report From the UAE

A 64-year-old man presented with a five-day history of high fever, diffuse joint pain, and generalized weakness following recent travel from Sri Lanka. On arrival, he appeared acutely ill, with significant pain-related immobility but no rash. Laboratory evaluation revealed mild leukopenia, lymphopenia, and elevated inflammatory markers, while initial serology was inconclusive. During hospitalization, he developed persistent fatigue, transient hypotensive episodes, and marked difficulty ambulating, necessitating close monitoring. Management included intravenous fluids, nonsteroidal anti-inflammatory drug (NSAID)-based analgesia, rest, and observation for complications such as persistent joint symptoms or cardiovascular instability. Over seven days, his fever resolved, blood pressure stabilized, and mobility gradually improved, allowing discharge in stable condition. This case highlights the importance of recognizing atypical presentations in older adults with fever and severe joint pain, particularly in patients with recent travel from regions with ongoing arboviral transmission. Close monitoring and supportive care facilitated recovery, and reporting such cases can aid in the timely recognition and management of similar presentations in nonendemic settings.