Singh Jitendra, Dinkar Anju, Singh Rana Gopal, Siddiqui Mohammad Si, Sinha Nikhil, Singh Sanjiv Kumar
Department of Medicine, Heritage Institute of Medical Science, Varanasi, Uttar Pradesh, India.
Department of Microbiology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Tzu Chi Med J. 2018 Jul-Sep;30(3):158-164. doi: 10.4103/tcmj.tcmj_138_17.
Arthropod-borne viral diseases are a major burden on the health-care system worldwide. Only a few studies have reported on coinfection of dengue fever (DF) with the chikungunya virus in North India. We investigated the seroprevalence and significance of the clinicobiochemical profile of dengue and chikungunya coinfection. Besides this, the authors try to emphasize rationalize platelets transfusion.
The present study was conducted at the Heritage Institute of Medical Science, Varanasi, India, from July to December 2016. A total of 1800 suspected cases with acute viral febrile illness (age >18 years) were investigated to exclude other causes of acute febrile illnesses. Of these, 121 patients (6.72%) were diagnosed as seropositive for dengue and chikungunya mono or coinfection using IgM ELISA and were included in the study.
The male gender was predominant. The majority were in the 20-30-year age group with cases peaking in November. There were 102 (84.29%) cases of dengue, 6 (4.95%) cases of chikungunya, and 13 (10.74%) cases positive for coinfection. Fever was present in all cases. Headache followed by nausea/vomiting and generalized weakness were the most common symptoms in patients with DF while body aches and joint pain were most common in those with chikungunya fever. Deranged liver function and leukopenia were the most common complications in dengue.
Joint-related symptoms (pain and restricted movements) were statistically significant in chikungunya monoinfection. Two patients with DF were died. There was no significant added severity of clinical features and blood investigations in patients with coinfection with dengue and chikungunya compared to those with monoinfections.
节肢动物传播的病毒性疾病是全球医疗保健系统的一项重大负担。在印度北部,仅有少数研究报道了登革热(DF)与基孔肯雅病毒的合并感染情况。我们调查了登革热与基孔肯雅病毒合并感染的血清阳性率及其临床生化特征的意义。除此之外,作者试图强调血小板输注的合理性。
本研究于2016年7月至12月在印度瓦拉纳西的遗产医学科学研究所进行。共对1800例急性病毒性发热疾病疑似病例(年龄>18岁)进行调查,以排除急性发热疾病的其他病因。其中,121例患者(6.72%)使用IgM ELISA诊断为登革热、基孔肯雅病毒单一感染或合并感染血清阳性,并纳入本研究。
男性占主导。大多数患者年龄在20 - 30岁之间,病例数在11月达到峰值。登革热病例102例(84.29%),基孔肯雅热病例6例(4.95%),合并感染阳性病例13例(10.74%)。所有病例均有发热症状。头痛伴恶心/呕吐和全身乏力是登革热患者最常见的症状,而身体疼痛和关节疼痛是基孔肯雅热患者最常见的症状。肝功能紊乱和白细胞减少是登革热最常见的并发症。
基孔肯雅病毒单一感染中与关节相关的症状(疼痛和活动受限)具有统计学意义。2例登革热患者死亡。与单一感染患者相比,登革热和基孔肯雅病毒合并感染患者的临床特征和血液检查结果并未显著加重。