Dengue and Chikungunya differential diagnosis in pediatric patients
Abstract
Introduction: Dengue and Chikungunya infections have similar clinical symptoms, which makes their clinical diagnosis complex. Moreover, both are transmitted by the same mosquito vectors, which results in virus co-circulation and co-infection. However, the outcome of these diseases differs: Chikungunya fever is rarely fatal but can have permanent and severe rheumatic and neurological sequelae, whereas dengue disease is potentially fatal. Thus, accurate diagnosis is critical. Objective: To compare presumptive diagnoses based on clinical findings with the differential diagnoses based on specific laboratory tests for each virus. Materials and methods: We performed specific virological and serological tests for both dengue and Chikungunya infections on eight acute-phase blood samples collected from pediatric patients with febrile syndrome. We used RT-PCR to detect dengue and Chikungunya virus, and IgM-capture ELISA to confirm infection by dengue virus. Results: Based on clinical findings, two patients were diagnosed as probable cases of dengue or Chikungunya, and two were diagnosed as probable cases of chikungunya. Four had no presumptive diagnosis of viral infection. Laboratory tests confirmed dengue infection in two patients, Chikungunya infection in two patients, and co-infection by the two viruses in the other four patients. Conclusion: Clinical findings were not sufficient to make a diagnosis in pediatric patients with febrile syndrome; specific laboratory tests were required to establish the etiologic agent of the disease.
Downloads
References
Bolling B, Weaver S, Tesh R, Vasilakis N. Insect-specific virus discovery: Significance for the arbovirus community. Viruses. 2015;7:4911-28. http://dx.doi.org/10.3390/v7092851
Rezza G. Dengue and chikungunya: Long-distance spread and outbreaks in naïve areas. Pathog Glob Health. 2014;108: 349-55. http://dx.doi.org/10.1179/2047773214Y.0000000163
Instituto Nacional de Salud. Boletín Epidemiológico Semanal. Sivigila. Semana 38 de 2015. Fecha de consulta: 3 de octubre de 2015. Disponible en: http://www.ins.gov.co/boletin-epidemiologico/Boletn%20Epidemiolgico/2015%20Boletin%20epidemiologico%20semana%2038.pdf
Hoz JM, Bayona B, Viloria S, Accini JL, Juan-Vergara HS. Fatal cases of Chikungunya virus infection in Colombia: Diagnostic and treatment challenges. J Clin Virol. 2015;69: 27-9. http://dx.doi.org/10.1016/j.jcv.2015.05.021
Mondragón-Cardona AE, Villamil-Gómez WE, Rodríguez-Morales A. Chikungunya congénito y neonatal: proble-mas emergentes en pediatría en Latinoamérica. Pediatr (Asunción). 2015;42:149-51. http://dx.doi.org/10.18004/ped. 2015.agosto.149-151
Cardona-Ospina JA, Henao-San Martín V, Paniz-Mondolfi AE, Rodríguez-MA. Mortality and fatality due to Chikungunya virus infection in Colombia. J Clin Virol. 2015;70:14-5. http://dx.doi.org/10.1016/j.jcv.2015.07.001
Restrepo AC, Baker P, Clements CA. National spatial and temporal patterns of notified dengue cases, Colombia 2007-2010. Trop Med Int Heal. 2014;19:863-71. http://dx.doi.org/10.1111/tmi.12325
Caglioti C, Lalle E, Castilletti C, Carletti F, Capobianchi MR, Bordi L. Chikungunya virus infection: An overview. New Microbiol. 2013;36:211-27.
Horstick O, Jaenisch T, Martínez E, Kroeger A, See LLC, Farrar J, et al. Comparing the usefulness of the 1997 and 2009 WHO dengue case classification: A systematic literature review. Am J Trop Med Hyg. 2014;91:621-34. http://dx.doi.org/10.4269/ajtmh.13-0676
San Martín JL, Brathwaite O, Zambrano B, Solórzano JO, Bouckenooghe A, Dayan GH, et al. The epidemiology of dengue in the Americas over the last three decades: A worrisome reality. Am J Trop Med Hyg. 2010;82:128-35. http://dx.doi.org/10.4269/ajtmh.2010.09-0346
Castrillón JC, Carlos J, Urcuqui S. Dengue en Colombia: diez años de evolución. Rev Chil Infectol. 2015;32:142-9. http://dx.doi.org/10.4067/S0716-10182015000300002
Instituto Nacional de Salud. Boletín Epidemiológico Semanal. Sivigila. Semana 53 de 2014. Fecha de consulta: 3 de octubre de 2015. Disponible en: http://www.ins.gov.co/boletin-epidemiologico/Boletn%20Epidemiolgico/2014%20Boletin%20epidemiologico%20semana%2053.pdf
Organización Panamericana de la Salud. Número de casos de fiebre Chikungunya en las Américas, 2015. Fecha de consulta: 3 de octubre 3 de 2015. Disponbile en: http://www.paho.org/hq/index.php?Itemid=40931
Castellanos JE, Coronel-Ruíz C. Dengue disease diag-nosis: A puzzle to be solved. Rev Fac Med. 2014;62:455-64. http://dx.doi.org/10.15446/revfacmed.v62n4.45593
Chien L, Liao T, Shu P, Gubler DJ, Chang GJ, Huang J. Development of real-time reverse transcriptase PCR assays to detect and serotype dengue viruses. J Clin Microbiol. 2006;44:1295-304. http://dx.doi.org/10.1128/JCM. 44.4.1295-1304.2006
Pastorino B, Bessaud M, Grandadam M, Murri S, Tolou HJ, Peyrefitte CN. Development of a TaqMan RT-PCR assay without RNA extraction step for the detection and quantification of African Chikungunya viruses. J Virol Methods. 2005;124:65-71. http://dx.doi.org/10.1016/j.jviromet.2004.11.002
Renault P, Solet JL, Sissoko D, Balleydier E, Larrieu S, Filleul L, et al. A major epidemic of chikungunya virus infection on Reunion Island, France, 2005-2006. Am J Trop Med Hyg. 2007;77:727-31.
Her Z, Kam YW, Lin RTP, Ng LF. Chikungunya: A bending reality. Microbes Infect. 2009;11:1165-76. http://dx.doi.org/10.1016/j.micinf.2009.09.004
Gérardin P, Fianu A, Malvy D, Mussard C, Boussaïd K, Rollot O, et al. Perceived morbidity and community burden after a Chikungunya outbreak: The TELECHIK survey, a population-based cohort study. BMC Med. 2011;9:5. http://dx.doi.org/10.1186/1741-7015-9-5
Chopra A, Anuradha V, Lagoo-Joshi V, Kunjir V, Salvi S, Saluja M. Chikungunya virus aches and pains: An emerging challenge. Arthritis Rheum. 2008;58:2921-2. http//dx.doi.org/10.1002/art.23753
Economopoulou A, Domínguez M, Helynck B, Sissoko D, Wichmann O, Quenel P, et al. Atypical Chikungunya virus infections: Clinical manifestations, mortality and risk factors for severe disease during the 2005-2006 outbreak on Reunion. Epidemiol Infect. 2009;137:534-41. http//dx. doi.org/10.1017/S0950268808001167
Tandale BV, Sathe PS, Arankalle VA, Wadia RS, Kulkarni R, Shah SV, et al. Systemic involvements and fatalities during Chikungunya epidemic in India, 2006. J Clin Virol. 2009;46:145-9. http://dx.doi.org/10.1016/j.jcv. 2009.06.027
Choudhry SP, Gupta RK, Kishan J. Dengue shock syndrome in new born – A case series. Indian Pediatr. 2004;41:397-9.
Sirinavin S, Nuntnarumit P, Supapannachart S, Boonkasidecha S, Techasaensiri C, Yoksarn S. Vertical dengue infection: Case reports and review. Pediatr Infect Dis J. 2004;23:1042-7. http://dx.doi.org/10.1097/01.inf. 0000143644.95692.0e
Maroun SL, Marliere RC, Barcellus RC, Barbosa CN, Ramos JR, Moreira M. Case report: Vertical dengue infection. J Pediatr (Rio J). 2008;84:556-9. http://dx.doi.org/10.1590/S0021-75572008000700014
Salgado DM, Rodríguez JA, Lozano LD, Zabaleta TE. Perinatal dengue. Biomédica. 2013;33(Suppl.1):14-21. http://dx.doi.org/10.7705/biomedica.v33i0.1449
Villamil-Gómez W, Alba-Silvera L, Menco-Ramos A, González-Vergara A, Molinares-Palacios T, Barrios-Corrales M, et al. Congenital chikungunya virus infection in Sincelejo, Colombia: A case series. J Trop Pediatr. 2015;61:386-92. http://dx.doi.org/10.1093/tropej/fmv051
Rolón P, Fonseca R, Genes L, Pereira S, Zapatta L. Chikungunya adquirida en recién nacidos. Reporte de caso. Pediatr (Asunción). 2015;42:42-7. http://dx.doi.org/10.18004/ ped.2015.abril.42-47
Passi GR, Khan YZ, Chitnis DS. Chikungunya infection in neonates. Indian Pediatr. 2008;45:240-1.
Gérardin P, Barau G, Michault A, Bintner M, Randrianaivo H, Choker G, et al. Multidisciplinary prospective study of mother-to-child chikungunya virus infections on the island of La Réunion. PLoS Med. 2008;5:e60. http://dx.doi.org/10. 1371/journal.pmed.0050060
Gérardin P, Sampériz S, Ramful D, Boumahni B, Bintner M, Alessandri J-L, et al. Neurocognitive outcome of children exposed to perinatal mother-to-child chikungunya virus infection: The CHIMERE Cohort Study on Reunion Island. PLoS Negl Trop Dis. 2014;8:e2996. http://dx.doi.org/110.1371/journal.pntd.0002996
Leroy EM, Nkoghe D, Ollomo B, Nze-Nkogue C, Becquart P, Grard G, et al. Concurrent chikungunya and dengue virus infections during simultaneous outbreaks, Gabon, 2007. Emerg Infect Dis. 2009;15:591-3. http://dx.doi.org/10. 3201/eid1504.080664
Omarjee R, Prat CM, Flusin O, Boucau S, Tenebray B, Merle O, et al. Importance of case definition to monitor ongoing outbreak of chikungunya virus on a background of actively circulating dengue virus, St Martin, December 2013 to January 2014. Euro Surveil. 2014;19:1-3.
Ratsitorahina M, Harisoa J, Ratovonjato J, Biacabe S, Reynes JM, Zeller H, et al. Outbreak of dengue and chikungunya fevers, Toamasina, Madagascar, 2006. Emerg Infect Dis. 2008;14:1135-7. http://dx.doi.org/10.3201/eid1407. 071521.
Laoprasopwattana K, Suntharasaj T, Petmanee P, Suddeaugrai O, Geater A. Chikungunya and dengue virus infections during pregnancy: Seroprevalence, seroincidence and maternal–fetal transmission, southern Thailand, 2009-2010. Epidemiol Infect. 2015;1-8. http://dx.doi.org/10.1017/S0950268815001065
Taraphdar D, Sarkar A, Mukhopadhyay BB, Chatterjee S. A comparative study of clinical features between monotypic and dual infection cases with chikungunya virus and dengue virus in West Bengal, India. Am J Trop Med Hyg. 2012;86:720-3. http://dx.doi.org/10.4269/ajtmh.2012.11-0704
Some similar items:
- Raúl A. Rojo-Ospina, Marcela Quimbayo-Forero, Arley Calle-Tobón, Sindy C. Bedoya-Patiño, Maribel Gómez, Astrid Ramírez, Johnny Sánchez, Juan F. Silva-Alzate, Carlos J. Montes-Zuluaga, Jorge M. Cadavid, Enrique A. Henao-Correa, Integrated vector management program in the framework of the COVID-19 pandemic in Medellin, Colombia , Biomedica: Vol. 43 No. 1 (2023)
- Doris Martha Salgado, Jairo Antonio Rodríguez, Liliana del Pilar Lozano, Tatiana Esther Zabaleta, Perinatal dengue , Biomedica: Vol. 33 (2013): Suplemento 1, Fiebres hemorrágicas
- Clara Beatriz Ocampo, Camila González, Carlos A. Morales, Mauricio Pérez, Dawn Wesson, Charles S. Apperson, Evaluation of community-based strategies for Aedes aegypti control inside houses , Biomedica: Vol. 29 No. 2 (2009)
- Juan Gabriel Piñeros, Margarita Arboleda, Juan Camilo Jaramillo, Silvia Blair, Report of five cases of severe neonatal Plasmodium vivax malaria in Urabá, Colombia , Biomedica: Vol. 28 No. 4 (2008)
- María Cristina Ferro, Victor Alberto Olano, Martha Ahumada, Scott Weaver, Mosquitos (Diptera: Culicidae) in the small village where a human case of Venezuelan equine encephalitis was recorded , Biomedica: Vol. 28 No. 2 (2008)
- Yolanda Cifuentes, Isabel De la Hoz, Martha Bermúdez, Clara Arteaga, Neonatal onset of organic acidemia (propionic) diagnosed by tandem mass spectrometry , Biomedica: Vol. 28 No. 1 (2008)
- Luis Miguel Sosa, Luz Libia Cala, Julio César Mantilla, Congenital tuberculosis associated with maternal disseminated miliary tuberculosis , Biomedica: Vol. 27 No. 4 (2007)
- María Elena Cuéllar-Jiménez, Olga Lucía Velásquez-Escobar, Ranulfo González-Obando, Carlos Andrés Morales-Reichmann, Detection of Aedes albopictus (Skuse) (Diptera: Culicidae) in the city of Cali, Valle del Cauca, Colombia , Biomedica: Vol. 27 No. 2 (2007)
- Lorenzo Cáceres , Cipriano Ayarza, Damaris Bernal, Evaluation of the biological efficacy and susceptibility in Aedes aegypti to the pyrethroid insecticides deltamethrin and cyfluthrin during the Zika virus outbreak in Kuna Yala, Panama , Biomedica: Vol. 43 No. 2 (2023)
- Berta Nelly Restrepo, Margarita Arboleda, Ruth Ramírez, Gonzalo Álvarez, Serum platelet-activating factor acetylhydrolase activity in dengue patients of African or mestizo descendency , Biomedica: Vol. 31 No. 4 (2011)
Article metrics | |
---|---|
Abstract views | |
Galley vies | |
PDF Views | |
HTML views | |
Other views |