Chikungunya: Difference between revisions
| Line 4: | Line 4: | ||
==Clinical Features== | ==Clinical Features== | ||
===Acute=== | |||
* [[Fever]] typically greater than 39deg | * [[Fever]] typically greater than 39deg | ||
* Polyarthralgias, bilateral and symmetrical | * Polyarthralgias, bilateral and symmetrical | ||
| Line 13: | Line 14: | ||
* AKI | * AKI | ||
* 3-7d incubation period | * 3-7d incubation period | ||
===Chronic=== | |||
*May cause long-term symptoms, with long-term musculoskeletal pain from months to years post infection<ref name="Gérardin R9">{{cite journal|last=Gérardin|first=P|coauthors=Fianu, A; Michault, A; Mussard, C; Boussaïd, K; Rollot, O; Grivard, P; Kassab, S; Bouquillard, E; Borgherini, G; Gaüzère, BA; Malvy, D; Bréart, G; Favier, F|title=Predictors of Chikungunya rheumatism: a prognostic survey ancillary to the TELECHIK cohort study.|journal=Arthritis research & therapy|date=Jan 9, 2013|volume=15|issue=1|pages=R9|pmid=23302155|doi=10.1186/ar4137}}</ref> with up to 60% of people reporting prolonged arthralgia three years following initial infection.<ref name="Schilte 2013 e2137">{{cite journal|last=Schilte|first=C|author2=Staikowsky, F |author3=Couderc, T |author4=Madec, Y |author5=Carpentier, F |author6=Kassab, S |author7=Albert, ML |author8=Lecuit, M |author9= Michault, A |displayauthors=9 |title=Chikungunya virus-associated long-term arthralgia: a 36-month prospective longitudinal study.|journal=PLoS neglected tropical diseases|year=2013|volume=7|issue=3|pages=e2137|pmid=23556021|doi=10.1371/journal.pntd.0002137}}</ref> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 10:25, 31 October 2014
Background
- Aedes mosquito transmitted virus, originally found in West Africa but cases in the Americas beginning in 2013
- Frequently difficult clinically to differentiate from dengue fever
Clinical Features
Acute
- Fever typically greater than 39deg
- Polyarthralgias, bilateral and symmetrical
- Rash- maculopapular
- Myalgias
- Nausea and vomiting
- Lymphocytopenia
- Elevated LFTs
- AKI
- 3-7d incubation period
Chronic
- May cause long-term symptoms, with long-term musculoskeletal pain from months to years post infection[1] with up to 60% of people reporting prolonged arthralgia three years following initial infection.[2]
Differential Diagnosis
Fever in traveler
- Normal causes of acute fever!
- Malaria
- Dengue
- Leptospirosis
- Typhoid fever
- Typhus
- Viral hemorrhagic fevers
- Chikungunya
- Yellow fever
- Rift valley fever
- Q fever
- Amebiasis
- Zika virus
- Papules
- Insect bites
- Scabies
- Seabather's eruption
- Cercarial dermatitis (Swimmer's Itch)
- Macular
- Sub Q Swelling and Nodules
- Ulcers
- Tropical pyoderma
- Leishmaniasis
- Mycobacterium marinum
- Buruli ulcer
- Dracunculiasis (Guinea Worm disease)
- Linear and Migratory Lesions
- Cutaneous larvae migrans
- Photodermatitis
See also domestic U.S. ectoparasites
Workup
- CBC w diff, Cr, LFTs
- contact CDC for specialized testing; recommends tiger top tube
Management
Symptomatic treatment: acute symptoms usually resolve in 7-10d
Disposition
- Normally able to be treated as outpatient, unless complication
See Also
External Links
Sources
CDC