Chikungunya differential diagnosis: Difference between revisions

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(/* Comparison between Chikungunya and Dengue Fever Adapted from Clin Infect Dis. (2009) 49(6):942-948.{{cite journal|last1=Staples|first1=J. Erin|last2=Breiman|first2=Robert F.|last3=Powers|first3=Ann M.|title=Chikungunya Fever: An Epidemiological Revi...)
(/* Comparison between Chikungunya and Dengue Fever Adapted from Clin Infect Dis. (2009) 49(6):942-948.{{cite journal|last1=Staples|first1=J. Erin|last2=Breiman|first2=Robert F.|last3=Powers|first3=Ann M.|title=Chikungunya Fever: An Epidemiological Revi...)
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* [[Shock]] or [[severe hemorrhage]] is very rarely observed in [[Chikungunya]].
* [[Shock]] or [[severe hemorrhage]] is very rarely observed in [[Chikungunya]].
* In Chikungunya the onset of the disease is more acute and the duration of [[fever]] is much shorter.
* In Chikungunya the onset of the disease is more acute and the duration of [[fever]] is much shorter.
* A maculopapular rash is more frequent in [[Chikungunya]] than in [[ dengue fever]].
* A [[maculopapular rash]] is more frequent in [[Chikungunya]] than in [[ dengue fever]].
* In [[Chikungunya]] the pain is much more pronounced and localized to the [[joints]] and [[tendons]] in comparison of [[dengue fever]], which the pain is generalized.
* In [[Chikungunya]] the pain is much more pronounced and localized to the [[joints]] and [[tendons]] in comparison of [[dengue fever]], which the pain is generalized.


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! style="width: 120px;background: #20538D"|{{fontcolor|#FFF| Dengue Fever}}
! style="width: 120px;background: #20538D"|{{fontcolor|#FFF| Dengue Fever}}
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Fever (>102°F or 39°C)
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|[[Fever]] (>102°F or 39°C)
| style="background: #FFF;font-weight: bold; text-align:center"| +++
| style="background: #FFF;font-weight: bold; text-align:center"| +++
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|++
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"| Headache  
|  style="width: 120px;font-weight: bold;background: #DCDCDC"| [[Headache]]
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|++
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"| Rash
|  style="width: 120px;font-weight: bold;background: #DCDCDC"| [[Rash]]
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|+
| style="background: #FFF;font-weight: bold; text-align:center"|+
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Arthalgias
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|[[Arthralgias]]
| style="background: #FFF;font-weight: bold; text-align:center"|+++
| style="background: #FFF;font-weight: bold; text-align:center"|+++
| style="background: #FFF;font-weight: bold; text-align:center"|+/–
| style="background: #FFF;font-weight: bold; text-align:center"|+/–
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Myalgias
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|[[Myalgias]]
| style="background: #FFF;font-weight: bold; text-align:center"| +
| style="background: #FFF;font-weight: bold; text-align:center"| +
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|++
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Shock
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|[[Shock]]
| style="background: #FFF;font-weight: bold; text-align:center"|—
| style="background: #FFF;font-weight: bold; text-align:center"|—
| style="background: #FFF;font-weight: bold; text-align:center"|+/–
| style="background: #FFF;font-weight: bold; text-align:center"|+/–
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Bleeding dyscrasias
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|[[Bleeding dyscrasias]]
| style="background: #FFF;font-weight: bold; text-align:center"|+/–
| style="background: #FFF;font-weight: bold; text-align:center"|+/–
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|++
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| style="background: #20538D"|
| style="background: #20538D"|
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Elevated hematocrit
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|[[Hematocrit#Elevated hematocrit|Elevated hematocrit]]
| style="background: #FFF;font-weight: bold; text-align:center"|—
| style="background: #FFF;font-weight: bold; text-align:center"|—
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|++
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"| Leukopenia
|  style="width: 120px;font-weight: bold;background: #DCDCDC"| [[Leukopenia]]
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|+++
| style="background: #FFF;font-weight: bold; text-align:center"|+++
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"| Neutropenia
|  style="width: 120px;font-weight: bold;background: #DCDCDC"| [[Neutropenia]]
| style="background: #FFF;font-weight: bold; text-align:center"|+
| style="background: #FFF;font-weight: bold; text-align:center"|+
| style="background: #FFF;font-weight: bold; text-align:center"|+++
| style="background: #FFF;font-weight: bold; text-align:center"|+++
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Lymphopenia
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|[[Lymphopenia]]
| style="background: #FFF;font-weight: bold; text-align:center"|+++
| style="background: #FFF;font-weight: bold; text-align:center"|+++
| style="background: #FFF;font-weight: bold; text-align:center"|++
| style="background: #FFF;font-weight: bold; text-align:center"|++
|-
|-
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|Thrombocytopenia
|  style="width: 120px;font-weight: bold;background: #DCDCDC"|[[Thrombocytopenia]]
| style="background: #FFF;font-weight: bold; text-align:center"|+
| style="background: #FFF;font-weight: bold; text-align:center"|+
| style="background: #FFF;font-weight: bold; text-align:center"|+++
| style="background: #FFF;font-weight: bold; text-align:center"|+++

Revision as of 20:41, 13 June 2014

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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

Chikunguyna must be differentiated from other diseases that present with flu like symptoms such as fever, headache, fatigue, joint aches or arthralgias, myalgias. Diseases with similar symptoms include dengue, influenza, measles, rubella, malaria, and yellow fever.

Differential Diagnosis


Comparison between Chikungunya and Dengue Fever Adapted from Clin Infect Dis. (2009) 49(6):942-948.[1]


Clinical and laboratory findings of chikunguyna and dengue fever
Clinical Findings Chikungunya Dengue Fever
Fever (>102°F or 39°C) +++ ++
Headache ++ ++
Rash ++ +
Arthralgias +++ +/–
Myalgias + ++
Shock +/–
Bleeding dyscrasias +/– ++
Laboratory Findings
Elevated hematocrit ++
Leukopenia ++ +++
Neutropenia + +++
Lymphopenia +++ ++
Thrombocytopenia + +++
Mean frequency of symptoms from studies where the two diseases were directly compared among patient seeking care; +++ = 70-100% of patients; ++ = 40-69%; + = 10-39%; +/– = <10%; — = 0%[2][3]

References

  1. Staples, J. Erin; Breiman, Robert F.; Powers, Ann M. (2009). "Chikungunya Fever: An Epidemiological Review of a Re‐Emerging Infectious Disease". Clinical Infectious Diseases. 49 (6): 942–948. doi:10.1086/605496. ISSN 1058-4838.
  2. S. Nimmannitya, S. B. Halstead, S. N. Cohen & M. R. Margiotta (1969). "Dengue and chikungunya virus infection in man in Thailand, 1962-1964. I. Observations on hospitalized patients with hemorrhagic fever". The American journal of tropical medicine and hygiene. 18 (6): 954–971. PMID 5355242. Unknown parameter |month= ignored (help)
  3. Patrick Hochedez, Ana Canestri, Amelie Guihot, Segolene Brichler, Francois Bricaire & Eric Caumes (2008). "Management of travelers with fever and exanthema, notably dengue and chikungunya infections". The American journal of tropical medicine and hygiene. 78 (5): 710–713. PMID 18458301. Unknown parameter |month= ignored (help)

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