Chikungunya natural history, complications and prognosis: Difference between revisions
No edit summary |
Gerald Chi (talk | contribs) mNo edit summary |
||
| Line 5: | Line 5: | ||
==Overview== | ==Overview== | ||
Complications are rare and include [[uveitis]], [[retinitis]], [[myocarditis]], [[hepatitis]], [[nephritis]], [[bullous]] skin lesions, [[hemorrhage]], [[meningoencephalitis]], [[myelitis]], [[Guillain-Barré syndrome]], and [[cranial nerve palsies]]. Persons at risk for severe disease include [[neonates]] exposed | |||
Complications are rare and include [[uveitis]], [[retinitis]], [[myocarditis]], [[hepatitis]], [[nephritis]], [[bullous]] skin lesions, [[hemorrhage]], [[meningoencephalitis]], [[myelitis]], [[Guillain-Barré syndrome]], and [[cranial nerve palsies]]. Persons at risk for severe disease include [[neonates]] exposed intrapartum, older adults (e.g., > 65 years), and persons with underlying medical conditions (e.g., [[hypertension]], [[diabetes]], or [[cardiovascular disease]]). Most patients recover uneventfully, but variable proportions of patients may have persistent [[arthralgias]] ([[joint pains]]) for months to years. | |||
==Natural History== | ==Natural History== | ||
In a 14-month prospective observational study among travelers from areas with outbreaks, nearly all confirmed cases had [[fever]], [[rash]], and [[arthritis]] within 10 days of the disease onset, and the majority had [[rheumatism]] persisting longer than 2 weeks, characterized by finger and toe [[polyarthritis]] with morning [[stiffness]], subacute [[tenosynovitis]] of wrists, hands, and ankles, or exacerbation of mechanic pain in previously injured joints and bones.<ref name="SimonParola2007">{{cite journal|last1=Simon|first1=Fabrice|last2=Parola|first2=Philippe|last3=Grandadam|first3=Marc|last4=Fourcade|first4=Sabrina|last5=Oliver|first5=Manuela|last6=Brouqui|first6=Philippe|last7=Hance|first7=Pierre|last8=Kraemer|first8=Philippe|last9=Mohamed|first9=Anzime Ali|last10=de Lamballerie|first10=Xavier|last11=Charrel|first11=R??mi|last12=Tolou|first12=Hugues|title=Chikungunya Infection|journal=Medicine|volume=86|issue=3|year=2007|pages=123–137|issn=0025-7974|doi=10.1097/MD/0b013e31806010a5}}</ref> | |||
==Complications== | ==Complications== | ||
*Complications are rare and include [[uveitis]], [[retinitis]], [[myocarditis]], [[hepatitis]], [[nephritis]], [[bullous]] skin lesions, [[hemorrhage]], [[meningoencephalitis]], [[myelitis]], [[Guillain-Barré syndrome]], and [[cranial nerve palsies]]. | |||
*Some patients may experience relapse of [[rheumatologic symptoms]] (e.g., [[polyarthralgia]], [[polyarthritis]], [[tenosynovitis]]) in the months following acute illness. | * Complications are rare and include [[uveitis]], [[retinitis]], [[myocarditis]], [[hepatitis]], [[nephritis]], [[bullous]] skin lesions, [[hemorrhage]], [[meningoencephalitis]], [[myelitis]], [[Guillain-Barré syndrome]], and [[cranial nerve palsies]]. | ||
* Some patients may experience relapse of [[rheumatologic symptoms]] (e.g., [[polyarthralgia]], [[polyarthritis]], [[tenosynovitis]]) in the months following acute illness. It has been suggested that musculoskeletal complications are immune-mediated, and the presence of [[autoantibodies]] has been reported in infected patients with rheumatic symptoms.<ref name="Maek-a-nantawatSilachamroon2009">{{cite journal|last1=Maek-a-nantawat|first1=Wirach|last2=Silachamroon|first2=Udomsak|title=Presence of Autoimmune Antibody in Chikungunya Infection|journal=Case Reports in Medicine|volume=2009|year=2009|pages=1–4|issn=1687-9627|doi=10.1155/2009/840183}}</ref> | |||
* Neurologic complications including [[encephalitis]], [[febrile seizure]]s, and [[encephalopathy|encephalopathies]] are common causes of hospitalization for pediatric patients with [[Chikungunya virus]] infection.<ref name="RobinRamful2008">{{cite journal|last1=Robin|first1=S.|last2=Ramful|first2=D.|last3=Le Seach|first3=F.|last4=Jaffar-Bandjee|first4=M.-C.|last5=Rigou|first5=G.|last6=Alessandri|first6=J.-L.|title=Neurologic Manifestations of Pediatric Chikungunya Infection|journal=Journal of Child Neurology|volume=23|issue=9|year=2008|pages=1028–1035|issn=0883-0738|doi=10.1177/0883073808314151}}</ref> | |||
===Risk factors for Complications=== | ===Risk factors for Complications=== | ||
Persons at risk for severe disease include [[neonates]] exposed | |||
Persons at risk for severe disease include [[neonates]] exposed intrapartum, older adults (e.g., > 65 years), and persons with underlying medical conditions (e.g., [[hypertension]], [[diabetes]], or [[cardiovascular disease]]). | |||
==Prognosis== | ==Prognosis== | ||
| Line 21: | Line 28: | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
==External Links== | |||
* [http://www.cdc.gov/Chikungunya/index.html CDC Chikungunya virus] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
| Line 30: | Line 40: | ||
[[Category:Togaviruses]] | [[Category:Togaviruses]] | ||
[[Category:Tropical disease]] | [[Category:Tropical disease]] | ||
Revision as of 22:43, 13 June 2014
|
Chikungunya Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Chikungunya natural history, complications and prognosis On the Web |
|
American Roentgen Ray Society Images of Chikungunya natural history, complications and prognosis |
|
FDA on Chikungunya natural history, complications and prognosis |
|
CDC on Chikungunya natural history, complications and prognosis |
|
Chikungunya natural history, complications and prognosis in the news |
|
Blogs on Chikungunya natural history, complications and prognosis |
|
Risk calculators and risk factors for Chikungunya natural history, complications and prognosis |
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
Complications are rare and include uveitis, retinitis, myocarditis, hepatitis, nephritis, bullous skin lesions, hemorrhage, meningoencephalitis, myelitis, Guillain-Barré syndrome, and cranial nerve palsies. Persons at risk for severe disease include neonates exposed intrapartum, older adults (e.g., > 65 years), and persons with underlying medical conditions (e.g., hypertension, diabetes, or cardiovascular disease). Most patients recover uneventfully, but variable proportions of patients may have persistent arthralgias (joint pains) for months to years.
Natural History
In a 14-month prospective observational study among travelers from areas with outbreaks, nearly all confirmed cases had fever, rash, and arthritis within 10 days of the disease onset, and the majority had rheumatism persisting longer than 2 weeks, characterized by finger and toe polyarthritis with morning stiffness, subacute tenosynovitis of wrists, hands, and ankles, or exacerbation of mechanic pain in previously injured joints and bones.[1]
Complications
- Complications are rare and include uveitis, retinitis, myocarditis, hepatitis, nephritis, bullous skin lesions, hemorrhage, meningoencephalitis, myelitis, Guillain-Barré syndrome, and cranial nerve palsies.
- Some patients may experience relapse of rheumatologic symptoms (e.g., polyarthralgia, polyarthritis, tenosynovitis) in the months following acute illness. It has been suggested that musculoskeletal complications are immune-mediated, and the presence of autoantibodies has been reported in infected patients with rheumatic symptoms.[2]
- Neurologic complications including encephalitis, febrile seizures, and encephalopathies are common causes of hospitalization for pediatric patients with Chikungunya virus infection.[3]
Risk factors for Complications
Persons at risk for severe disease include neonates exposed intrapartum, older adults (e.g., > 65 years), and persons with underlying medical conditions (e.g., hypertension, diabetes, or cardiovascular disease).
Prognosis
Most patients recover uneventfully. Mortality is rare. Risk factors for death include older age.
References
- ↑ Simon, Fabrice; Parola, Philippe; Grandadam, Marc; Fourcade, Sabrina; Oliver, Manuela; Brouqui, Philippe; Hance, Pierre; Kraemer, Philippe; Mohamed, Anzime Ali; de Lamballerie, Xavier; Charrel, R??mi; Tolou, Hugues (2007). "Chikungunya Infection". Medicine. 86 (3): 123–137. doi:10.1097/MD/0b013e31806010a5. ISSN 0025-7974.
- ↑ Maek-a-nantawat, Wirach; Silachamroon, Udomsak (2009). "Presence of Autoimmune Antibody in Chikungunya Infection". Case Reports in Medicine. 2009: 1–4. doi:10.1155/2009/840183. ISSN 1687-9627.
- ↑ Robin, S.; Ramful, D.; Le Seach, F.; Jaffar-Bandjee, M.-C.; Rigou, G.; Alessandri, J.-L. (2008). "Neurologic Manifestations of Pediatric Chikungunya Infection". Journal of Child Neurology. 23 (9): 1028–1035. doi:10.1177/0883073808314151. ISSN 0883-0738.