VARIOUS CLINICAL PRESENTATIONS OF CHIKUNGUNYA FEVER AND ITS OUTCOME

BACKGROUND Chikungunya is an emerging and rapidly spreading disease with varied clinical scenario/presentations, affecting largely areas colonized by the Aedes mosquito. Diagnosing, treating of Chikungunya fever and post Chikungunya (pCHIK) inflammatory arthritis is a challenging problem in both tropical and sub-tropical countries. Aim of the study is to find various clinical scenarios/presentations of Chikungunya fever and its outcome, so that it may help physicians to diagnose Chikungunya accurately. MATERIALS AND METHODS This prospective study includes 94 Chikungunya confirmed patients. Patients were diagnosed with Chikungunya using Chikungunya specific IgM antibodies test kits. Patient details were collected, local and systemic examination was done. Specific treatment using NSAIDS, Hydroxychloroquine and Steroids was given to patients based on clinical manifestations and the outcome was assessed. RESULTS Out of 94 Chikungunya confirmed patients, 100% had fever, polyarthralgia noticed among 90.4%, other presentations were malaise (87.2%), swelling of joints (74.4%), headache (76.5%), myalgia (72.3%), stiffness of joints (55.3%), dysgeusia (36.1%), bleeding manifestations (34%), cervical lymphadenopathy (23.4%), organomegaly (12.7%), cutaneous hypersensitivity (17%), depression (13.8%). Out of 94 patients, 24 (25.5%) responded promptly to simple analgesics like paracetamol or NSAIDS. 52 (55.3%) were treated with NSAIDS and Hydroxychloroquine combination. 18 (19.1%) severely toxic patients with persistent severe polyarthritis were treated with steroids along with hydroxychloroquine and NSAIDS. CONCLUSION When laboratory testing is restricted or during an outbreak it’s a challenge for physicians to identify Chikungunya accurately based on clinical case definition in order to treat disease promptly and to stop progression of disease.