Chikungunya history and symptoms: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Chikungunya}} | {{Chikungunya}} | ||
{{CMG}}; {{AE}} {{AL}} | {{CMG}}; {{AE}} {{AL}}; {{Alonso}}; {{VR}} | ||
==Overview== | ==Overview== | ||
Chikungunya | Chikungunya which follows a bite of an infected mosquito [[Aedes aegypti]] or [[Aedes albopictus]] carrying chikungunya [[virus]], can either present as an asymptomatic or as a symptomatic disease. The most common symptoms of the symptomatic disease include [[fever]], [[arthralgia]] or [[polyarthritis]], and [[maculopapular rash]]. | ||
The common symptoms of | |||
==Symptoms== | ==Symptoms== | ||
While | While few infected with chikungunya virus become asymptomatic (around 3-28%),<ref name="pmid18156079">{{cite journal| author=Queyriaux B, Simon F, Grandadam M, Michel R, Tolou H, Boutin JP| title=Clinical burden of chikungunya virus infection. | journal=Lancet Infect Dis | year= 2008 | volume= 8 | issue= 1 | pages= 2-3 | pmid=18156079 | doi=10.1016/S1473-3099(07)70294-3 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18156079 }} </ref><ref name="pmid20207883">{{cite journal| author=Moro ML, Gagliotti C, Silvi G, Angelini R, Sambri V, Rezza G et al.| title=Chikungunya virus in North-Eastern Italy: a seroprevalence survey. | journal=Am J Trop Med Hyg | year= 2010 | volume= 82 | issue= 3 | pages= 508-11 | pmid=20207883 | doi=10.4269/ajtmh.2010.09-0322 | pmc=PMC2829919 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20207883 }} </ref> most of the individuals will develop some symptoms after an incubation period of 3-7 days (range: 1-12 days). The symptoms of the disease can manifest as any of the following clinical forms. | ||
===Acute Disease=== | ===Acute Disease=== | ||
The following are the acute symptoms that usually last for 3–10 days. | The following are the acute symptoms that usually last for 3–10 days. | ||
*High fever: High fever is the most characteristic acute symptom. It is usually | *[[High fever]]: High fever is the most characteristic acute symptom. It is usually | ||
**Sudden in onset. | **Sudden in onset. | ||
**Lasts from several days up to a week. | **Lasts from several days up to a week. | ||
**Typically >39°C [102°F]. | **Typically >39°C [102°F]. | ||
**Continuous or intermittent. | **Continuous or intermittent. | ||
**May be associated with relative bradycardia. | **May be associated with relative [[bradycardia]]. | ||
* | *[[Arthralgia]] or [[polyarthritis]]: [[Arthralgia]] or [[polyarthritis]] is another characteristic acute symptom of the disease that follows fever. Polyarthritis is usually | ||
**Symmetrical. | **Symmetrical. | ||
**Affects 10 or >10 joint groups. | **Affects 10 or >10 joint groups. | ||
**Most commonly involves the hands and feet, but can also affect the proximal joints. | **Most commonly involves the hands and feet, but can also affect the proximal joints. | ||
**Associated with tenosynovitis. | **Associated with [[tenosynovitis]]. | ||
**Severe and debilitating, confining the patients to bed and thus affecting their normal day to day activities. | **Severe and debilitating, confining the patients to bed and thus affecting their normal day to day activities. | ||
*[[Rash]]: Half the patients are affected by rash that usually occurs 2-5 days after the onset of fever. The rashes are | *[[Rash]]: Half the patients are affected by rash that usually occurs 2-5 days after the onset of fever. The rashes are | ||
**Typically [[maculopapular]]. | **Typically [[maculopapular]]. | ||
**Involve the trunk and extremities, and can also include the palms, soles, and face. | **Involve the trunk and extremities, and can also include the palms, soles, and face. | ||
**Can also manifest as diffuse erythema that blanches with pressure. | **Can also manifest as diffuse [[erythema]] that blanches with pressure. | ||
**Vesiculobullous lesions, the most common skin presentation in infants. | **[[Vesiculobullous]] lesions, the most common skin presentation in infants. | ||
* Other symptoms may include [[headache]], [[myalgia]], [[conjunctivitis]], [[nausea]], [[vomiting]], and diffuse back pain. | * Other symptoms may include [[headache]], [[myalgia]], [[conjunctivitis]], [[nausea]], [[vomiting]], and diffuse [[back pain]]. | ||
===Subacute and Chronic Disease=== | ===Subacute and Chronic Disease=== | ||
| Line 37: | Line 35: | ||
*Swollen and stiff joints | *Swollen and stiff joints | ||
*Swollen joints with fine desquamation | *Swollen joints with fine [[desquamation]] | ||
*Hyperpigmentation | *Hyperpigmentation | ||
*Tenosynovitis | *[[Tenosynovitis]] | ||
*Hygroma | *[[Hygroma]] | ||
===Atypical Manifestations=== | ===Atypical Manifestations=== | ||
Besides the typical symptoms, the disease can atypically present with any of the following clinical manifestations due to the virus itself, immunological response to the virus, or drug toxicity.<ref name="pmid19716149">{{cite journal| author=Rajapakse S, Rodrigo C, Rajapakse A| title=Atypical manifestations of chikungunya infection. | journal=Trans R Soc Trop Med Hyg | year= 2010 | volume= 104 | issue= 2 | pages= 89-96 | pmid=19716149 | doi=10.1016/j.trstmh.2009.07.031 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19716149 }} </ref> | Besides the typical symptoms, the disease can atypically present with any of the following clinical manifestations due to the virus itself, immunological response to the virus, or drug toxicity.<ref name="pmid19716149">{{cite journal| author=Rajapakse S, Rodrigo C, Rajapakse A| title=Atypical manifestations of chikungunya infection. | journal=Trans R Soc Trop Med Hyg | year= 2010 | volume= 104 | issue= 2 | pages= 89-96 | pmid=19716149 | doi=10.1016/j.trstmh.2009.07.031 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19716149 }} </ref> | ||
*Neurological: | *[[Neurological]]: | ||
** | **[[Cerebellar syndrome]] | ||
** | **[[Encephalitis]] | ||
** | **[[Encephalopathy]] | ||
** | **[[Guillain-Barré syndrome]] | ||
** | **[[Meningoencephalitis]] | ||
** | **[[Neuropathy]] | ||
** | **[[Seizures]] | ||
*Ocular: | *[[Ocular]]: | ||
**Optic neuritis | **[[Optic neuritis]] | ||
**Iridocyclitis | **[[Iridocyclitis]] | ||
**Episcleritis | **[[Episcleritis]] | ||
**Retinitis | **[[Retinitis]] | ||
*Cardiovascular | *[[Cardiovascular]]: | ||
**Myocarditis | **[[Myocarditis]] | ||
**Pericarditis | **[[Pericarditis]] | ||
**Heart failure | **[[Heart failure]] | ||
**Arrhythmias | **[[Arrhythmias]] | ||
**Ischemic heart disease | **[[Ischemic heart disease]] | ||
**Hemodynamic instability | **[[Hemodynamic instability]] | ||
*Skin: | *[[Skin]]: | ||
**Photosensitive hyperpigmentation | **[[Photosensitive hyperpigmentation]] | ||
**Penoscrotal ulcers | **[[Penoscrotal ulcers]] | ||
**Vesiculobullous dermatosis | **[[Vesiculobullous dermatosis]] | ||
*Renal: | *[[Renal]]: | ||
**Nephritis | **[[Nephritis]] | ||
**Acute renal failure | **[[Acute renal failure]] | ||
*Neonatal infection with vertical transmission: | *[[Neonatal]] infection with vertical transmission: | ||
**Ante-partum fetal deaths | **[[Ante-partum fetal deaths]] | ||
**Meningoencephalitis | **[[Meningoencephalitis]] | ||
**Disseminated intravascular coagulation | **[[Disseminated intravascular coagulation]] | ||
*Other possible associations: | *Other possible associations: | ||
**Pneumonia | **[[Pneumonia]] | ||
**Respiratory failure | **[[Respiratory failure]] | ||
**Hepatitis | **[[Hepatitis]] | ||
**Pancreatitis | **[[Pancreatitis]] | ||
**SIADH | **[[SIADH]] | ||
**Hypoadrenalism | **[[Hypoadrenalism]] | ||
==References== | ==References== | ||
Revision as of 17:45, 13 June 2014
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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]; Vendhan Ramanujam M.B.B.S [4]
Overview
Chikungunya which follows a bite of an infected mosquito Aedes aegypti or Aedes albopictus carrying chikungunya virus, can either present as an asymptomatic or as a symptomatic disease. The most common symptoms of the symptomatic disease include fever, arthralgia or polyarthritis, and maculopapular rash.
Symptoms
While few infected with chikungunya virus become asymptomatic (around 3-28%),[1][2] most of the individuals will develop some symptoms after an incubation period of 3-7 days (range: 1-12 days). The symptoms of the disease can manifest as any of the following clinical forms.
Acute Disease
The following are the acute symptoms that usually last for 3–10 days.
- High fever: High fever is the most characteristic acute symptom. It is usually
- Sudden in onset.
- Lasts from several days up to a week.
- Typically >39°C [102°F].
- Continuous or intermittent.
- May be associated with relative bradycardia.
- Arthralgia or polyarthritis: Arthralgia or polyarthritis is another characteristic acute symptom of the disease that follows fever. Polyarthritis is usually
- Symmetrical.
- Affects 10 or >10 joint groups.
- Most commonly involves the hands and feet, but can also affect the proximal joints.
- Associated with tenosynovitis.
- Severe and debilitating, confining the patients to bed and thus affecting their normal day to day activities.
- Rash: Half the patients are affected by rash that usually occurs 2-5 days after the onset of fever. The rashes are
- Typically maculopapular.
- Involve the trunk and extremities, and can also include the palms, soles, and face.
- Can also manifest as diffuse erythema that blanches with pressure.
- Vesiculobullous lesions, the most common skin presentation in infants.
- Other symptoms may include headache, myalgia, conjunctivitis, nausea, vomiting, and diffuse back pain.
Subacute and Chronic Disease
Subacute and chronic disease can manifest as any of the following after an acute stage.
- Swollen and stiff joints
- Swollen joints with fine desquamation
- Hyperpigmentation
- Tenosynovitis
- Hygroma
Atypical Manifestations
Besides the typical symptoms, the disease can atypically present with any of the following clinical manifestations due to the virus itself, immunological response to the virus, or drug toxicity.[3]
- Neurological:
- Ocular:
- Cardiovascular:
- Skin:
- Renal:
- Neonatal infection with vertical transmission:
- Other possible associations:
References
- ↑ Queyriaux B, Simon F, Grandadam M, Michel R, Tolou H, Boutin JP (2008). "Clinical burden of chikungunya virus infection". Lancet Infect Dis. 8 (1): 2–3. doi:10.1016/S1473-3099(07)70294-3. PMID 18156079.
- ↑ Moro ML, Gagliotti C, Silvi G, Angelini R, Sambri V, Rezza G; et al. (2010). "Chikungunya virus in North-Eastern Italy: a seroprevalence survey". Am J Trop Med Hyg. 82 (3): 508–11. doi:10.4269/ajtmh.2010.09-0322. PMC 2829919. PMID 20207883.
- ↑ Rajapakse S, Rodrigo C, Rajapakse A (2010). "Atypical manifestations of chikungunya infection". Trans R Soc Trop Med Hyg. 104 (2): 89–96. doi:10.1016/j.trstmh.2009.07.031. PMID 19716149.