Clinical and laboratory profiles of children with severe chikungunya infection

Medical records of children with positive IgM for the chikungunya virus who were hospitalized in a pediatric ward in Fortaleza, Ceará, Brazil were analyzed.

RESULTS:

Fourteen children with a median age of 4 months (36 days to 15 years) were included. All patients presented with fever persisting for an average of 5 days. The joints were involved in 6 (42.8%) children, and 8 (57.1%) children presented with bullous rash.

CONCLUSIONS:

Systemic involvement and atypical clinical manifestations characterize severe forms of chikungunya infection in children.

Keywords:
Chikungunya vírus; Children; Infants; Atypical manifestations

	Clinical features
			Symptoms													Signs
Patient	Age	Gender	Fever	Arthralgia/Arthritis	Myalgia	Asthenia	Ocular pain	Conjunctivitis	Headache	Diarrhea	Nausea	Vomiting	Rash	Bleeding	Abdominal pain	Bulging fontanelle
1	15 y	F	Yes	Yes	No	No	No	No	No	No	No	Yes	Yes	No	No	No
2	13 y	F	Yes	Yes	No	No	No	No	Yes	No	No	No	Yes*	No	Yes	No
3	2 m	M	Yes	No	NE	No	NE	No	NE	Yes	NE	No	Yes*	No	Yes	No
4	4 m	F	Yes	No	NE	Yes	NE	No	NE	No	NE	No	Yes*	No	No	Yes
5	1 m	F	Yes	No	NE	No	NE	No	NE	Yes	NE	No	Yes*	No	No	No
6	1 m	M	Yes	No	NE	No	NE	No	NE	No	NE	No	Yes*	No	No	No
7	15 y	M	Yes	Yes	Yes	Yes	No	No	Yes	No	No	Yes	No	No	Yes	No
8	3 m	M	Yes	No	NE	No	NE	No	NE	No	NE	No	Yes	No	No	Yes
9	1 m	F	Yes	No	NE	No	NE	No	NE	No	NE	No	Yes*	No	No	No
10	2 m	M	Yes	No	NE	No	NE	No	NE	No	NE	No	Yes*	No	No	No
11	6 m	F	Yes	No	NE	No	NE	No	NE	No	NE	No	Yes*	No	No	No
12	15 y	F	Yes	Yes	Yes	No	No	No	Yes	No	Yes	Yes	Yes	No	No	No
13	8 y	M	Yes	Yes	No	No	No	No	No	No	No	No	Yes	No	No	No
14	4 m	M	Yes	Yes	NE	Yes	NE	No	NE	No	NE	No	Yes	No	No	No

Patients	1	2	3	4	5	6	7	8	9	10	11	12	13	14
Hemoglobin, g/dL	12.1	12.6	7.6	9.8	7.2	9.6	12.4	9	10.9	8.7	11	8.9	12.4	10.2
Hematocrit, %	34.8	37.3	22.5	28.8	22.2	29.3	43	27.9	33.8	27.8	31.2	29.3	38.1	29.7
Platelet on admission, 10³/mm³	211	273	67.4	414	123	152	201	116	127	193	216	123	330	103
Lowest platelet counts, 10³/mm³	211	238	37	314	123	152	168	116	127	193	210	123	330	57
Leukocyte counts, 10³/mm³	10	4.5	3	9.6	5.54	7.24	6.39	7.74	9.09	13	8.4	5.08	7.56	5.4
Lymphocyte counts (%)	39	38	44	13.5	66.2	75	34.3	65	50	58	46	45	28	60
Highest AST, IU/L	105	61	252	-	193	244	59	-	202	216	201	26	89	139
Highest ALT, IU/L	203	20	59	-	54	68	35	-	61	66	103	17	352	38
INR	-	1.0	-	-	-	1.1	-	-	0.93	-	-	-	-	-
Albumin, g/dL	3.8	3.5	2.2	-	2.7	3.2	4.2	-	3.3	3.3	-	-	-	-
BUN, mg/dL	12	8	30	-	27	11	27	-	7	6	-	7	21	33
Creatinine, mg/dL	0.5	-	0.4	0.3	0.4	0.4	0.9	-	0.3	0.3	-	0.6	0.8	0.4
Sodium, mmol/L	142	-	146	143	-	140	-	-	136	127	-	-	136	132
Potassium, mmol/L	4.0	-	4.9	4.4	-	5	-	-	5.3	5.9	-	-	4.1	5.3

Sociedade Brasileira de Medicina Tropical - SBMT Caixa Postal 118, 38001-970 Uberaba MG Brazil, Tel.: +55 34 3318-5255 / +55 34 3318-5636/ +55 34 3318-5287, http://rsbmt.org.br/ - Uberaba - MG - Brazil
E-mail: rsbmt@uftm.edu.br

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[1] Corresponding author: Roberto da Justa Pires Neto. e-mail:robertojusta@ufc.br