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寨卡症状在寨卡登革热流行中的临床意义。

Clinical relevance of Zika symptoms in the context of a Zika Dengue epidemic.

机构信息

Departamento de Epidemiología Hospitalaria, Hospital Docente Clínico Quirúrgico "Joaquín Albarrán", La Habana, Cuba.

Servicio de Medicina Interna, Hospital Docente Clínico Quirúrgico "Joaquín Albarrán", La Habana, Cuba.

出版信息

J Infect Public Health. 2020 Feb;13(2):173-176. doi: 10.1016/j.jiph.2019.07.006. Epub 2019 Aug 6.

Abstract

BACKGROUND

The clinical characteristics of the most frequent arbovirosis (Dengue, Zika, Chikungunya) are very similar, which is a diagnostic challenge for clinicians.

OBJECTIVE

To identify the presence of clinical characteristics related to Zika virus infection confirmed by the laboratory in patients during an epidemic of co-infection with Zika and Dengue viruses.

METHOD

Cross-sectional descriptive study of patients with clinical - epidemiological suspicion of Zika virus infection, who were admitted in the Hospital "Joaquín Albarrán" (La Habana, Cuba), during June 1 to October 31 of 2017. Demographic and symptoms and signs were recorded. By PCR for Zika virus (in blood or urine) the disease was confirmed.

RESULTS

1541 patients were studied. The most frequent symptoms and signs were rash (93.8%), pruritus (77.9%), arthralgia (60.0%), headache (50.8%), myalgia (46.1%), fever (34.7%), asthenia (31.7%), and conjunctivitis (27.9%). Zika virus infection was confirmed in 279 patients (18.1%). Greater frequency of arthralgia, asthenia, and diarrhea was demonstrated in Zika confirmed patients.

CONCLUSION

Minor clinical relevance was observed in the symptoms or signs of arboviral disease to support the clinical diagnosis of Zika virus infections by clinician during a Zika-Dengue epidemic. The assessment of the temporality of the onset of Zika and Dengue symptoms of these infections is recommended to assist clinicians in the differential diagnosis.

摘要

背景

最常见的虫媒病毒病(登革热、寨卡病毒、基孔肯雅热)的临床特征非常相似,这对临床医生来说是一个诊断挑战。

目的

在寨卡病毒和登革热病毒同时流行期间,确定实验室确诊的寨卡病毒感染患者的临床特征。

方法

对 2017 年 6 月 1 日至 10 月 31 日期间在哈瓦那“华金·阿尔瓦兰”医院(古巴)因临床-流行病学疑似寨卡病毒感染而入院的患者进行了一项横断面描述性研究。记录了人口统计学和症状及体征。通过聚合酶链反应(PCR)检测血液或尿液中的寨卡病毒,从而确诊该病。

结果

共研究了 1541 例患者。最常见的症状和体征是皮疹(93.8%)、瘙痒(77.9%)、关节痛(60.0%)、头痛(50.8%)、肌痛(46.1%)、发热(34.7%)、乏力(31.7%)和结膜炎(27.9%)。279 例患者(18.1%)被确诊为寨卡病毒感染。在确诊为寨卡病毒感染的患者中,关节痛、乏力和腹泻的发生率更高。

结论

在寨卡病毒病的症状或体征方面,观察到较小的临床相关性,以支持临床医生在寨卡-登革热流行期间对寨卡病毒感染进行临床诊断。建议评估这些感染的寨卡和登革热症状的发病时间,以帮助临床医生进行鉴别诊断。

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