Abstract
Abstract Introduction: the infection of chikungunya virus presents clinical manifestations variables, particularly in infants in which may present multiple cutaneous manifestations. Description: a case series study was carried out in an analytical character of 14 infants (>28 days to < 2 years old) admitted in a hospital between November 2015 and January 2016 with suspected case of chikungunya, by a specific IgM reactive serology. Patients positive for dengue fever, Zika virus, bacterial infections and other exanthematic diseases were excluded. Fever and cutaneous alterations were the most frequent clinical manifestations in 100% of the cases, followed by irritability (64.3%), vomits and arthralgia/arthritis in 35.7% each. Three children presented alterations in the cerebrospinal fluid compatible to meningitis. Anemia frequency was 85.7%. The median white blood cells count was 7.700/mm3 (2.600 to 20.300/mm3). High levels of aminotransferases were observed in three cases (230 to 450 U/L). Antibiotic therapy was indicated in 64.3% of the cases. Two infants needed opioid derivatives for analgesia while others took acetaminophen and/or dipyrone. Discussion: the study shows evident multi-systemic involvement of chikungunya infection in infants. The treatment is supportive, giving special attention to hydration, analgesia, skin care, and rational use of antibiotic therapy.
Highlights
Chikungunya is a arbovirus caused by chikungunya virus (CHIKV) of the simple RNA chain, Alphavirus gender, Togaviridae classification and is transmitted to humans by the main vectors identified as the Aedes aegypti and Aedes albopictus mosquitos bite
The four infants who presented blisters were treated with topical silver sulfadiazine after cleansing with 0.9% SF while those with exanthema used vegetable oil with medium-chain triglycerides (TCM). This case series describes clinical, laboratorial and therapeutic characteristics of a specific age group hospitalized with laboratorial diagnosis confirmed for Chikungunya infection
This present study describes the first documented cases in Brazil of infants with atypical and severe manifestations caused by CHIKV in the period of November 2015 to January 2016
Summary
Chikungunya is a arbovirus caused by chikungunya virus (CHIKV) of the simple RNA chain, Alphavirus gender, Togaviridae classification and is transmitted to humans by the main vectors identified as the Aedes aegypti and Aedes albopictus mosquitos bite. The objective of this study was to describe and analyze clinical, laboratorial and therapeutic characteristics for hospitalized infants with chikungunya infection. This is a case series study in an analytical character performed through the identification of cases reported suspected of being chikungunya infection at the Epidemiology Nucleus at the Instituto de Medicina Integral Prof. Infants (>28 days to < 2 years) admitted at IMIP suspected of chikungunya infection by specific laboratorial confirmation were included. The evaluated variables were gender, age, weight, origin, clinical manifestations, including cutaneous, osteoarticular and neurological, peripheral cyanosis, duration of fever, comorbidities, length of hospital stay, laboratory characteristics and therapeutic measurements used (type of venous access, volume expansion, antibiotic therapy, analgesia, skin care and blood transfusion). The four infants who presented blisters were treated with topical silver sulfadiazine after cleansing with 0.9% SF while those with exanthema used vegetable oil with medium-chain triglycerides (TCM)
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