急性腹部是基孔肯雅热的不典型表现

Luiz Reis Júnior, A. Mendes, C. Ramos
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摘要

简介:基孔肯雅热是由基孔肯雅病毒(CHIKV)引起的虫媒病毒。由于特征性发热和关节痛,这是登革热的主要鉴别诊断之一。病例报告:一名8岁黑人男性患者有腹痛史,伴每日发热、吞咽困难和虚弱。它随着肌痛和多关节痛的发展而演变。随后,他被送去接受调查。临床持续恶化,持续发热,腹痛加重。住院8天后出现肠穿孔及感染性休克症状。手术稳定后,患者接受血清学检查,并经Elisa确认感染了CHIKV。讨论:大多数感染基孔肯雅病毒的个体会出现症状性感染(70%)。与其他虫媒病毒相比,数值很高。临床体征和症状与登革热相似——急性发热、关节痛和肌痛、头痛、恶心、疲劳和皮疹。有些病例可能发展为非典型,其特征是出现严重症状或表现出较少的临床表现,例如本病例。严重框架的频率为0.3%。结论:可能出现不常见的表现,儿科医生应提高警惕,并将其作为鉴别诊断。
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Acute abdomen as atypical manifestation of chikungunya
INTRODUCTION: Chikungunya fever is an arbovirus caused by the chikungunya virus (CHIKV). It is one of the main differential diagnoses of dengue, due to characteristic fever and arthralgia. CASE REPORT: An 8-year-old Black male patient had a history of abdominal pain associated with daily fever, odynophagia and asthenia. It evolved over the days with myalgia and polyarthralgia. He was then admitted for investigation. Maintained clinical worsening with persistent fever and increased abdominal pain. After 8 days of hospitalization showed signs of intestinal perforation and septic shock. After surgery and stabilization, he underwent serology and confirmed CHIKV infection by Elisa. DISCUSSION: Most individuals infected with the chikungunya virus develop symptomatic infection (70%). High values compared to other arboviruses. The signs and symptoms are clinically similar to those of dengue fever - acute onset fever, arthralgia and myalgia, headache, nausea, fatigue and rash. Some cases may develop atypically, characterized by the appearance of signs of severity or by presenting less frequent clinical manifestations, such as those in this case. The frequency of severe frames is 0.3%. CONCLUSION: Less common manifestations may occur, and pediatricians should be alert and consider CHIKV infection as a differential diagnosis.
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