Evidence of acute rickettsioses among patients presumed to have chikungunya fever during the chikungunya outbreak in Sri Lanka
Autor(es)Premaratna R, Halambarachchige L P, Nanayakkara D M, Chandrasena T G A N, Rajapakse R P V J, Bandara N K B K R G W, de Silva H J
ResumoChikungunya fever (CGF) - rickettsioses are known to cause acute onset febrile illnesses associated with severe arthritis. Rickettsial arthritis is curable with the use of appropriate anti-rickettsial antibiotics, however the arthritis of CGF tends to have a prolonged course leading to protracted disability. The aim of this study was to investigate the contribution of CGF - rickettsioses to cases of fever - arthritis during a presumed CGF outbreak in Sri Lanka. Fifty-eight consecutive patients with presumed CGF were further investigated to determine the occurrence of rickettsioses among them, - to identify differences in clinical, hematological, - biochemical parameters between the two diseases. Nearly a third of the patients had serological evidence of rickettsioses accounting for their illness. The presence of a late onset major joint arthropathy sparing the small joints of the h-s - feet, - the occurrence of a late onset discrete maculopapular rash over the trunk - extremities, suggested rickettsioses over CGF. White blood cell count, erythrocyte sedimentation rate, C-reactive protein, - liver function tests were not helpful in differentiating rickettsioses from CGF. Patients with rickettsioses - arthritis who received an empirical course of doxycycline recovered faster than those who did not receive specific treatment. The establishment of rapid diagnostic methods able to differentiate the etiological agents of fever - arthritis, such as CGF - rickettsioses, would be beneficial in endemic settings.
Palavras-ChaveRickettsioses; Chikungunya fever; Arthritis; Clinical differentiation
ImprentaInternational Journal of Infectious Diseases, v. 15, n. 12, p. e871-e873, 2011
Identificador do Objeto Digital10.1016/j.ijid.2011.09.010
DescritoresChikungunya virus - Cell ; Chikungunya virus - Pathogenesis ; Chikungunya virus - Proteins ; Chikungunya virus - Antibodies ; Chikungunya virus - Viral infections ; Chikungunya virus - Serological diagnosis ; Chikungunya Virus - Virus ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Epidemiology ; Chikungunya virus - Immunology ; Chikungunya virus - Public health ; Chikungunya virus - Rash maculopapular
Data de Publicação:2011
