Autor(es): Pröll S, Dobler G, Pfeffer M, Jelinek T, Nothdurft H D, Löscher T

Resumo: A 57-year-old patient presented with malaise - severe persistent arthralgia of the left shoulder. He reported an acute illness with fever, generalized myalgia - arthralgias of the large joints which had started one month earlier during his flight back to Germany after a two weeks trip to the South Pacific. Physical examination showed extensive pain on palpation of the glenohumeral - acromioclavicular joints with impairment of active - passive mobility. Investigation of the cervical spine was normal. Apart from elevated C-reactive protein - erythrocyte sedimentation rate levels, routine laboratory investigations were normal including negative immunodiagnostic tests for autoantibodies - various global infections that may be associated with arthritis. Immunofluorescence tests showed significant levels of specific IgM- - IgG-antibodies against Ross River virus (RRV) but not against other arboviruses endemic in the South Pacific - Australia (Dengue, West Nile, Chikungunya, Sindbis, Barmah Forest). This was confirmed by a positive RRV neutralisation test. Attempts at virus isolation - detection of viral RNA by PCR were not successful. Symptomatic treatment with high doses of diclofenac quickly led to pain relief, - arthralgias receded within 10 days after begin of treatment. However, several bouts of arthralgia of the left shoulder - left knee occurred during a period of 4 months. Because of the current epidemiological situation in the South Pacific - Australia, infections by arboviruses like RRV should be considered in travellers returning from these areas with severe - persistent arthralgia of unknown origin, even in the absence of fever - other symptoms of acute infection.

Imprenta: Deutsche Medizinische Wochenschrift, v. 124, n. 24, p. 759-762, 1999

Identificador do objeto digital: 10.1055/s-2007-1024409

Descritores: Chikungunya virus - Arbovirus; Chikungunya virus - Pathogenesis; Chikungunya virus - Proteins; Chikungunya virus - RNA; Chikungunya virus - Antibodies; Chikungunya virus - Viral infections; Chikungunya virus - Clinical examination; Chikungunya virus - PCR detection; Chikungunya Virus - Virus; Chikungunya virus - Chikungunya fever; Chikungunya virus - Dengue; Chikungunya virus - Immunology

Data de publicação: 1999