Chikungunya natural history, complications and prognosis: Difference between revisions

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Revision as of 14:00, 13 June 2014

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).

Natural History

Most patients recover uneventfully, but variable proportions of patients may have persistent arthralgias (joint pains) for months to years.

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.

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

CDC Chikungunya virus

@@ Line 5: / Line 5: @@
 ==Overview==
-* Rare complications include [[uveitis]], [[retinitis]], [[myocarditis]], [[hepatitis]], [[nephritis]], [[bullous]] skin lesions, [[hemorrhage]], [[meningoencephalitis]], [[myelitis]], [[Guillain-Barré syndrome]], and [[cranial nerve palsies]].
+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]]).
-* 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]]).
-* Some patients might have relapse of [[rheumatologic symptoms]] (e.g., [[polyarthralgia]], [[polyarthritis]], [[tenosynovitis]]) in the months following acute illness.
+==Natural History==
-* Studies report variable proportions of patients with persistent [[joint pains]] for months to years.
+Most patients recover uneventfully, but variable proportions of patients may have persistent [[arthralgias]] ([[joint pains]]) for months to years.
-* Mortality is rare and occurs mostly in older adults.
+==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.
+===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==