Chikungunya physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Chikungunya}} | {{Chikungunya}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{AL}}, {{Alonso}} | ||
==Overview== | |||
Chikungunya usually presents with clinical signs such as [[fever]], [[Maculopapular|skin rashes]], and joint swelling with effusions that can be detected during a physical examination. | |||
==Physical Examination== | ==Physical Examination== | ||
===Fever=== | |||
The disease is characterized by an acute onset of high [[fever]], typically more than 39°C (102°F). | |||
===Skin=== | ===Skin=== | ||
* [[Maculopapular rash]] | * [[Maculopapular rash]] | ||
* Nasal blotchy [[erythema]] | * Nasal blotchy [[erythema]] | ||
* [[Freckle]]-like pigmentation over centro-facial area | * [[Freckle]]-like pigmentation over centro-facial area | ||
* [[Flagellate]] pigmentation on face and extremities | * [[Flagellate]] [[pigmentation]] on face and extremities | ||
* Lichenoid eruption and hyperpigmentation in photodistributed areas | * [[Lichenification|Lichenoid]] [[eruption]] and [[hyperpigmentation]] in photodistributed areas | ||
* Multiple aphthous-like [[ulcer]]s over [[scrotum]], crural areas and [[axilla]]. | * Multiple [[aphthous]]-like [[ulcer]]s over [[scrotum]], crural areas and [[axilla]]. | ||
* | * [[Lymphedema]] in acral distribution (bilateral/unilateral) | ||
* Multiple ecchymotic spots ( | * Multiple [[ecchymosis|ecchymotic spots]] (children) | ||
* Vesiculobullous [[lesion]]s (infants) | * Vesiculobullous [[lesion]]s (infants) | ||
* Subungual [[hemorrhage]] | * Subungual [[hemorrhage]] | ||
* Photo [[urticaria]] | * Photo [[urticaria]] | ||
* Acral [[urticaria]] | * Acral [[urticaria]] | ||
===Joints=== | |||
* [[Polyarthralgia]] usually symmetric and often occur in hands and feet | |||
* Periarticular [[swelling]] and joint effusion in knees. | |||
==Gallery <SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from ''Preparedness and Response for Chikungunya Virus: Introduction in the Americas. PAHO © 2011.''<ref name=PAHO2011>{{cite book | last = | first = | title = Preparedness and response for Chikungunya virus introduction in the Americas | publisher = Pan American Health Organization CDC, Center for Disease Control and Prevention | location = Washington, DC | year = 2011 | isbn = 978-92-75-11632-6 }}</ref></SMALL></SMALL></SMALL></SMALL></SMALL>== | |||
===Acute Disease=== | |||
<gallery> | |||
File:Chikungunya clinical presentation acute disease 01.jpg|[[Edema|Edematous]] [[rash]] of the face | |||
File:Chikungunya clinical presentation acute disease 02.jpg|[[Edema|Edematous]] [[polyarthritis]] of the hands | |||
File:Chikungunya clinical presentation acute disease 03.jpg|[[Erythema]] that blanches with pressure | |||
File:Chikungunya clinical presentation acute disease 04.jpg|Periarticular [[swelling]] and joint effusion in knees | |||
File:Joint manifestation of Chikungunya.png|Joint effusion in right knee | |||
File:Joint manifestation of Chikungunya 2.png|Arthritis in left hand | |||
File:Chikungunya clinical presentation acute disease 05.jpg|[[Maculopapular rash]] in trunk and extremities | |||
File:Chikungunya clinical presentation acute disease 06.jpg|[[Maculopapular rash]] in extremities, including palms | |||
File:Chikungunya clinical presentation acute disease 07.jpg|Bullous lesions in infant leg | |||
File:Chikungunya clinical presentation acute disease 08.jpg|Infant with [[maculopapular rash]], [[petechial]] spots and erythema of upper and lower limbs associated with [[edema]] of the extremities | |||
File:Chikungunya clinical presentation acute disease 09.jpeg|[[Maculopapular rash]] in the trunk | |||
File:Chikungunya clinical presentation acute disease 10.jpeg|[[Maculopapular rash]] in the feet | |||
</gallery> | |||
===Subacute and Chronic Disease=== | |||
<gallery> | |||
File:Chikungunya clinical presentation subacute or chronic disease 01.jpg|End of the acute stage. [[Swelling|Swollen]] hands and fine [[desquamation]] | |||
File:Chikungunya clinical presentation subacute or chronic disease 02.jpg|[[Hyperpigmentation]] | |||
File:Chikungunya clinical presentation subacute or chronic disease 03.jpg|[[Tenosynovitis]] in hands | |||
File:Chikungunya clinical presentation subacute or chronic disease 04.jpg|[[Tenosynovitis]] in ankle | |||
File:Chikungunya clinical presentation subacute or chronic disease 05.jpg|Elbow [[hygroma]] | |||
File:Chikungunya clinical presentation subacute or chronic disease 06.jpg|[[Swelling|Swollen]] and [[stiffness|stiff]] hands in a 55-year-old man who was infected 5 years earlier | |||
</gallery> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
==External Links== | |||
* [http://www.cdc.gov/Chikungunya/index.html CDC Chikungunya virus] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Viral diseases]] | [[Category:Viral diseases]] | ||
[[Category:Togaviruses]] | [[Category:Togaviruses]] | ||
[[Category:Tropical disease]] | [[Category:Tropical disease]] | ||
Latest revision as of 17:23, 18 September 2017
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Chikungunya physical examination On the Web |
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American Roentgen Ray Society Images of Chikungunya physical examination |
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Risk calculators and risk factors for Chikungunya physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2], Alonso Alvarado, M.D. [3]
Overview
Chikungunya usually presents with clinical signs such as fever, skin rashes, and joint swelling with effusions that can be detected during a physical examination.
Physical Examination
Fever
The disease is characterized by an acute onset of high fever, typically more than 39°C (102°F).
Skin
- Maculopapular rash
- Nasal blotchy erythema
- Freckle-like pigmentation over centro-facial area
- Flagellate pigmentation on face and extremities
- Lichenoid eruption and hyperpigmentation in photodistributed areas
- Multiple aphthous-like ulcers over scrotum, crural areas and axilla.
- Lymphedema in acral distribution (bilateral/unilateral)
- Multiple ecchymotic spots (children)
- Vesiculobullous lesions (infants)
- Subungual hemorrhage
- Photo urticaria
- Acral urticaria
Joints
- Polyarthralgia usually symmetric and often occur in hands and feet
- Periarticular swelling and joint effusion in knees.
Gallery Adapted from Preparedness and Response for Chikungunya Virus: Introduction in the Americas. PAHO © 2011.[1]
Acute Disease
-
-
Edematous polyarthritis of the hands -
Erythema that blanches with pressure -
Periarticular swelling and joint effusion in knees -
Joint effusion in right knee -
Arthritis in left hand -
Maculopapular rash in trunk and extremities -
Maculopapular rash in extremities, including palms -
Bullous lesions in infant leg -
Infant with maculopapular rash, petechial spots and erythema of upper and lower limbs associated with edema of the extremities -
Maculopapular rash in the trunk -
Maculopapular rash in the feet
Subacute and Chronic Disease
-
End of the acute stage. Swollen hands and fine desquamation -
-
Tenosynovitis in hands -
Tenosynovitis in ankle -
Elbow hygroma -
References
- ↑ Preparedness and response for Chikungunya virus introduction in the Americas. Washington, DC: Pan American Health Organization CDC, Center for Disease Control and Prevention. 2011. ISBN 978-92-75-11632-6.