Clinical Behavior of Dengue and Chikungunya Infections in the Instituto Mexicano del Seguro Social

Abstract

Arbovirus infections have increased worldwide in the last years and specific differential diagnosis may be difficult owing to their similar clinical presentations. Here we describe and compare the clinical manifestations of dengue and chikungunya fever. Material and Methods: In order to portray the clinical behavior of both diseases, a cross-sectional study was performed including patients insured by the Mexican Institute for Social Security (IMSS), their demographic data, and clinical signs and symptoms. Laboratory parameters were analyzed. Results: One thousand four hundred and ninety-five dengue and 1810 chikungunya cases were studied. All patients presented fever, whereas headache, myalgias, mild arthralgias, and ocular pain were more frequent in dengue cases. Severe incapacitating polyarthralgias, arthritis, and conjunctivitis were present only in chikungunya cases. Also, edema and exanthema were more frequent in patients with chikungunya. Liquid leak to tissues and hemorrhage were more frequent among dengue cases. Platelet counts were lower in hemorrhagic dengue (P < 0.001). Laboratory parameters were altered between the second and third day of evolution and tended to return to normal from the fifth day. Discussion: The clinical features observed in this group of patients may contribute to the differential diagnosis of both diseases. The cardinal signs of severity were not present in all cases of any of the two diseases. It is important to consider these issues in order to establish an early diagnosis and improve the prognosis of patients. KeywordsChikungunya, Behavior, Clinical J. Navarrete-Espinosa et al. 24

Chikungunya in solid organ transplant recipients, a case series and literature review

“…In our series, none of the patients developed severe complications, graft rejection, or died from the infection. Mild or transient arthralgia and fever were the most common symptoms observed in our case series of SOT recipients with CHIKV infection, which is consistent with published reports . Among all case series reviewed, arthralgia lasting more than 5 days was present in 30%‐46% of the SOT recipients with CHIKV infection .…”