Naik Korra Dhanunjaya, Delhi Kumar C G, Abimannane Anitha, Dhodapkar Rahul, Biswal Niranjan
Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India.
Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India.
J Trop Pediatr. 2024 Dec 5;71(1). doi: 10.1093/tropej/fmae057.
The clinical profile and outcomes of children with chikungunya infection differ from those observed in adults. As there is a paucity of data on chikungunya infection in children, this study aimed to find the clinical course, complications, and mortality rates of chikungunya infection in children. This was a combined retrospective and prospective observational study. Children aged 1 month to 15 years who tested positive for chikungunya infection by IgM enzyme-linked immunosorbent assay and reverse transcription polymerase chain reaction in serum or body fluids were included. The demographic details, clinical presentation, laboratory parameters, treatment given, and outcomes were recorded in a structured proforma. Fifty-eight cases (41 retrospective and 17 prospective) were recruited, out of which 30 (52%) were males. The median age was 8 (3-11) years. The most common clinical feature at admission was fever observed in 55 patients (94.8%), followed by vomiting [25 (43.1%)] and myalgia [23 (39.7%)]. Commonly observed clinical signs were skin rash [32 (55.2%)], hepatomegaly [25 (43.1%)], and anemia [22 (37.9%)]. Frequently observed acute complications were lymphopenia [46 (79.3%)], hyponatremia [32 (55.2%)], capillary leak [27 (46.6%)], and thrombocytopenia [26 (44.8%)]. Of 58 cases, 8 (13.8%) children had co-infection with other microbes. Overall, 55 (94.8%) children had complete recovery, 2 (3.4%) children died of complications (one with acute encephalitis and one child with acute respiratory distress syndrome), and 5 children had prolonged arthralgia. Children with chikungunya had more skin manifestations and neurological manifestations than arthralgia. Also, a significant proportion of children developed serious complications like a capillary leak.
基孔肯雅热感染儿童的临床特征和预后与成人不同。由于关于儿童基孔肯雅热感染的数据匮乏，本研究旨在探寻儿童基孔肯雅热感染的临床病程、并发症及死亡率。这是一项回顾性与前瞻性相结合的观察性研究。纳入了年龄在1个月至15岁之间、血清或体液中通过IgM酶联免疫吸附测定和逆转录聚合酶链反应检测基孔肯雅热感染呈阳性的儿童。人口统计学细节、临床表现、实验室参数、给予的治疗及预后情况均记录在一份结构化表格中。共招募了58例病例（41例回顾性病例和17例前瞻性病例），其中30例（52%）为男性。中位年龄为8（3 - 11）岁。入院时最常见的临床特征是发热，55例患者（94.8%）出现发热，其次是呕吐[25例（43.1%）]和肌痛[23例（39.7%）]。常见的临床体征有皮疹[32例（55.2%）]、肝肿大[25例（43.1%）]和贫血[22例（37.9%）]。常见的急性并发症有淋巴细胞减少[46例（79.3%）]、低钠血症[32例（55.2%）]、毛细血管渗漏[27例（46.6%）]和血小板减少[26例（44.8%）]。58例病例中，8例（13.8%）儿童合并有其他微生物感染。总体而言，55例（94.8%）儿童完全康复，2例（3.4%）儿童因并发症死亡（1例死于急性脑炎，1例死于急性呼吸窘迫综合征），5例儿童有关节痛迁延不愈。基孔肯雅热感染儿童的皮肤表现和神经表现比关节痛更多见。此外，相当一部分儿童出现了如毛细血管渗漏等严重并发症。
