基孔肯雅热在马来西亚与登革热混淆:临床、血清学和分子观点

Umi Kalsom Ali, I. Isahak, M. Rahman
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引用次数: 12

摘要

本研究旨在观察基孔肯雅病毒热患者的临床、血清学和分子诊断,并与登革热病毒热进行比较。其中包括49例血清学阴性但临床有登革热样症状的登革热患者。进行临床调查,记录住院患者的不同概况。采用Onsite®基孔肯雅IgM组合快速检测进行血清学检测,采用分子检测RT-PCR检测患者血清中的病毒。其中19例(38.7%)血清学确诊为基孔肯雅热感染。有趣的是,患者血清分子检测未发现基孔肯雅病毒,但在9例患者血清中检测到登革热病毒。记录基孔肯雅病毒感染患者的典型临床特征,以区分基孔肯雅与登革热,主要表现为发热、关节痛、肌痛和皮疹。在这些人群中检测到基孔肯雅IgM意味着这种病毒虽然没有登革热那么多,但全年都在传播。实验室确认对于区分基孔肯雅热和登革热很重要。本研究在当地数据中增加了一些信息,希望能帮助临床医生在暴发和非暴发环境中对基孔肯雅感染进行临床和实验室诊断和管理。已证明血清学在确认基孔肯雅热感染方面是有用的。
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Chikungunya confused with dengue in Malaysia: Clinical, serological and molecular perspective
This study was to observe clinical, serolgical and molecular diagnosis of chikungunya viral fever patients and its comparison with dengue viral fever. For that 49 serologically negative dengue patients but clinically dengue like symptomms were included. Clinical investigation was carried out recording different profiles of hospitalized patients. Serology was performed using the Onsite® Chikungunya IgM Combo rapid test and molecular test RT-PCR was performed to detect the virus in the patients sera. It was observed that out of them 19 (38.7 %) were serologically confirmed chikungunya infection. Interestingly molecular detection of the patients sera did not show the presence chikungunya virus but detected dengue virus from 9 patients’s sera. Classical clinical features of chikungunya virus infected patients were recorded to differentiate chikungunya from dengue, which were fever, arthralgia, myalgia and rash. Detection of chikungunya IgM in these cohort means that this virus is circulating throughout the year although not as many as dengue. Laboratory confirmation is important to differentiate chikungunya fever from dengue fever. This study adds some information in local data and hopefully can help the clinicians to clinically and laboratory diagnosis and management of chikungunya infection in outbreak and non-outbreak setting. Serology was proven to be useful in confirming chikungunya infection.
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