Mesquita Ramirez Mirta Noemi, Rodriguez Leonidas Adelaida, Pavlicich Sonia Viviana, Wuyk Antonella, Ortiz Cynthia, Arevalos Fernando, Morilla Laura
From the Teaching and Research Department, Pediatric General Hospital "Children of Acosta Ñu".
Teaching and Research Department of the Pediatric General Hospital Children of Acosta Ñu, Catholic University of Our Lady of Asuncion.
Pediatr Infect Dis J. 2025 Oct 1;44(10):920-924. doi: 10.1097/INF.0000000000004853. Epub 2025 May 15.
Clinical manifestations of Chikungunya fever (CHIKV) in children include fever, skin lesions and joint pain. CHIKV rarely leads to septic shock in children. The aim of this study was to describe the epidemiological characteristics, clinical presentation and evolution of patients with CHIKV admitted at the Pediatric Emergency Department of a public hospital in Asunción, Paraguay, during the 2023 epidemic in this country.
The study was retrospective and observational. The patients included were 0 to 18 years old, with CHIKV diagnosis confirmed by reverse transcription polymerase chain reaction between February 1 and March 30, 2023. The variables analyzed included demographic data, pediatric assessment triangle (PAT), disease evolution prior to admission, signs and symptoms at admission, admission to the pediatric intensive care unit and status at discharge. The study was approved by the Ethics Committee of the hospital.
A total of 200 patients were admitted. Of them, 57.5% were infants ≤60 days of age, and 56.5% were male. Symptoms included fever (99%), rash (76.5%), shock at the PAT (60.5%), prolonged capillary filling (57.5%), seizures (15%) and myalgias/arthralgias (11%). Besides, 57.2% had septic shock within 24 hours of admission, associated with age ≤60 days [odds ratio (OR): 2; 95% confidence interval (CI): 1.1-3.5; P = 0.01] and altered PAT (OR: 3.5; 95% CI:1.8-6.6; P = 0.0001), 15% were admitted to the pediatric intensive care unit, and 2.5% died.
Results showed a predominance of febrile infants with altered PAT who presented septic shock within the first 24 hours of hospital admission, 15% of patients with seizures and 2.5% who died.
基孔肯雅热（CHIKV）在儿童中的临床表现包括发热、皮肤病变和关节疼痛。CHIKV在儿童中很少导致感染性休克。本研究的目的是描述2023年巴拉圭亚松森一家公立医院儿科急诊科收治的CHIKV患者的流行病学特征、临床表现及病情演变。
本研究为回顾性观察性研究。纳入的患者年龄在0至18岁之间，2023年2月1日至3月30日期间经逆转录聚合酶链反应确诊为CHIKV感染。分析的变量包括人口统计学数据、儿科评估三角（PAT）、入院前疾病演变、入院时的体征和症状、入住儿科重症监护病房情况及出院状态。本研究获医院伦理委员会批准。
共收治200例患者。其中，57.5%为年龄≤60天的婴儿，56.5%为男性。症状包括发热（99%）、皮疹（76.5%）、PAT评估为休克（60.5%）、毛细血管充盈时间延长（57.5%）、惊厥（15%）和肌痛/关节痛（11%）。此外，57.2%的患者在入院24小时内发生感染性休克，与年龄≤60天[比值比（OR）：2；95%置信区间（CI）：1.1 - 3.5；P = 0.01]及PAT异常（OR：3.5；95% CI：1.8 - 6.6；P = 0.0001）相关，15%的患者入住儿科重症监护病房，2.5%的患者死亡。
结果显示，以PAT异常的发热婴儿为主，这些婴儿在入院后24小时内出现感染性休克，15%的患者发生惊厥，2.5%的患者死亡。
