Chikungunya physical examination

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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]

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 rash of the face
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
Hyperpigmentation
Tenosynovitis in hands
Tenosynovitis in ankle
Elbow hygroma
Swollen and stiff hands in a 55-year-old man who was infected 5 years earlier

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.

External Links

CDC Chikungunya virus

[PAHO2011-1] 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.

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