Chikungunya physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2], Alonso Alvarado, M.D. [3]
Overview
Chikungunya usually presents with clinical signs such as fever, skin rashes, and joint swelling with effusions that can be detected during a physical examination.
Physical Examination
Fever
The disease is characterized by an acute onset of high fever, typically more than 39°C (102°F).
Skin
- Maculopapular rash
- Nasal blotchy erythema
- Freckle-like pigmentation over centro-facial area
- Flagellate pigmentation on face and extremities
- Lichenoid eruption and hyperpigmentation in photodistributed areas
- Multiple aphthous-like ulcers over scrotum, crural areas and axilla.
- Lymphedema in acral distribution (bilateral/unilateral)
- Multiple ecchymotic spots (children)
- Vesiculobullous lesions (infants)
- Subungual hemorrhage
- Photo urticaria
- Acral urticaria
Joints
- Polyarthralgia usually symmetric and often occur in hands and feet
- Periarticular swelling and joint effusion in knees.
Gallery Adapted from Preparedness and Response for Chikungunya Virus: Introduction in the Americas. PAHO © 2011.[1]
Acute Disease
Edematous polyarthritis of the hands
Erythema that blanches with pressure
Periarticular swelling and joint effusion in knees
Joint effusion in right knee
Arthritis in left hand
Maculopapular rash in trunk and extremities
Maculopapular rash in extremities, including palms
Bullous lesions in infant leg
Infant with maculopapular rash, petechial spots and erythema of upper and lower limbs associated with edema of the extremities
Maculopapular rash in the trunk
Maculopapular rash in the feet
Subacute and Chronic Disease
End of the acute stage. Swollen hands and fine desquamation
Tenosynovitis in hands
Tenosynovitis in ankle
Elbow hygroma
References
- ↑ Preparedness and response for Chikungunya virus introduction in the Americas. Washington, DC: Pan American Health Organization CDC, Center for Disease Control and Prevention. 2011. ISBN 978-92-75-11632-6.