Chikungunya physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2], Alonso Alvarado, M.D. [3]
Overview
Chikungunya usually presents with clinical signs such as fever, skin rashes, and joint swelling with effusions that can be detected during a physical examination.
Physical Examination
Fever
The disease is characterized by an acute onset of high fever, typically more than 39°C (102°F).
Skin
- Maculopapular rash
- Nasal blotchy erythema
- Freckle-like pigmentation over centro-facial area
- Flagellate pigmentation on face and extremities
- Lichenoid eruption and hyperpigmentation in photodistributed areas
- Multiple aphthous-like ulcers over scrotum, crural areas and axilla.
- Lymphedema in acral distribution (bilateral/unilateral)
- Multiple ecchymotic spots (children)
- Vesiculobullous lesions (infants)
- Subungual hemorrhage
- Photo urticaria
- Acral urticaria
Joints
- Polyarthralgia usually symmetric and often occur in hands and feet
- Periarticular swelling and joint effusion in knees.
Gallery Adapted from Preparedness and Response for Chikungunya Virus: Introduction in the Americas. PAHO © 2011.[1]
Acute Disease
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Edematous polyarthritis of the hands
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Erythema that blanches with pressure
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Periarticular swelling and joint effusion in knees
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Joint effusion in right knee
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Arthritis in left hand
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Maculopapular rash in trunk and extremities
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Maculopapular rash in extremities, including palms
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Bullous lesions in infant leg
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Infant with maculopapular rash, petechial spots and erythema of upper and lower limbs associated with edema of the extremities
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Maculopapular rash in the trunk
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Maculopapular rash in the feet
Subacute and Chronic Disease
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End of the acute stage. Swollen hands and fine desquamation
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Tenosynovitis in hands
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Tenosynovitis in ankle
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Elbow hygroma
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References
- ↑ Preparedness and response for Chikungunya virus introduction in the Americas. Washington, DC: Pan American Health Organization CDC, Center for Disease Control and Prevention. 2011. ISBN 978-92-75-11632-6.