Chikungunya: Difference between revisions
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===Chronic===
===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>
*May cause long-term symptoms, with long-term musculoskeletal pain from months to years post infection<ref>Gérardin et al.  "Predictors of Chikungunya rheumatism: a prognostic survey ancillary to the TELECHIK cohort study."  Arthritis research & therapy.  Jan 9, 2013. 15(1). pmid=23302155. doi=10.1186/ar4137</ref>


==Differential Diagnosis==
==Differential Diagnosis==

Revision as of 12:20, 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

Chikungunya rash on foot
  • 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]

Differential Diagnosis

Fever in traveler

Travel-related skin conditions

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

  1. ↑ Gérardin et al. "Predictors of Chikungunya rheumatism: a prognostic survey ancillary to the TELECHIK cohort study." Arthritis research & therapy. Jan 9, 2013. 15(1). pmid=23302155. doi=10.1186/ar4137
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