Sharda Meenaxi, Meena H
Department of Medicine, Medical College and Associated Group of Hospitals, Kota, Rajasthan.
J Assoc Physicians India. 2007 Nov;55:765-9.
The present prospective study was undertaken to study the clinical manifestations and mainly neurological complication of an acute febrile illness termed chikungunya which has recently attacked india after 43 years.
This prospective study has been conducted in hospitalised patients admitted in government and private hospitals of Kota city from August 2006 to October 2006. Patients showing neurological involvement with typical clinical picture of chikungunya infection were studied in detail and followed up for improvement and any permanent damage or death.
Apart from typical clinical triad of high grade fever, arthralgia and rash of chikungunya infection we have observed a spectrum of neurological abnormalities in terms of altered mental functions, seizures, focal neurological deficit with abnormal CT scan of head and altered CSF biochemistry. Permanent neurological sequelae and even death has occurred.
Typical clinical history of chikungunya infection, neurological complications with associated CSF abnormalities, supportive laboratory evidences, positive chikungunya IgM card test, exclusion of other causes and known predilection of arboviruses for CNS infection allows us to conclude the diagnosis of study cases as Chikungunya Encephalitis.
开展本前瞻性研究,以探讨一种名为基孔肯雅热的急性发热性疾病的临床表现及主要神经并发症,该疾病在43年后近期侵袭了印度。
本前瞻性研究于2006年8月至2006年10月在科塔市公立和私立医院收治的住院患者中进行。对表现出神经受累且具有基孔肯雅热感染典型临床表现的患者进行详细研究,并随访其病情改善情况以及是否出现任何永久性损伤或死亡。
除了基孔肯雅热感染典型的高热、关节痛和皮疹三联征外,我们还观察到一系列神经异常,包括精神功能改变、癫痫发作、伴有头颅CT扫描异常的局灶性神经功能缺损以及脑脊液生化改变。出现了永久性神经后遗症甚至死亡情况。
基孔肯雅热感染的典型临床病史、伴有脑脊液异常的神经并发症、支持性实验室证据、基孔肯雅热IgM卡式试验阳性、排除其他病因以及已知虫媒病毒对中枢神经系统感染的偏好,使我们能够将研究病例诊断为基孔肯雅热脑炎。