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CIKUNGUNYA
dd demam + nyeri sendi
covid-19
SLE (Sistemik Lupus Eritematosus)
Demam rematik
Septic athritis
RA
definition, risk factor & etiologi
Chikungunya virus (CHIKV) is an arthropod-borne alphavirus that belongs to the family Togaviridae transmitted by Aedes mosquitoes. The virus is known for causing an acute febrile illness, rash, and arthralgia known as Chikungunya fever followed by potentially chronic and debilitating arthritic symptoms that may last for months or years
Today, CHIKV is widespread worldwide and is a global public health concern.
The primary vectors for CHIKV are Aedes aegypti and Ae. albopictus (Asian Tiger mosquito)
Risk factors for the disease consist of travel to affected areas or anywhere with mosquitoes and mosquito bites
The proximity of mosquito vector breeding sites to human habitation is a significant risk factor for chikungunya as well as for other diseases that Aedes mosquito species transmit
History and Physical
Chikungunya fever usually presents with the non-specific findings of high-grade fever and myalgia, following a 3 to 7 day incubation period, and lasting around 3 to 5 days. Bilateral symmetrical polyarthralgia ensues 2 to 5 days after the onset of fevers and preferentially involves distal over proximal joints.
Another common clinical manifestation is a generalized maculopapular rash that usually involves the extremities first and arises 3 days after the fever symptoms. Although rare, vesiculobullous and mucocutaneous lesions have also been reported
Manifestations such as abdominal pain, diarrhea, vomiting, and generalized lymphadenopathy may also be found. Although it is not considered to be a neurotropic virus, it has long been associated with neurologic symptoms, with encephalitis among newborns infected through mother-to-child transmission being the most common
study in Puerto Rico, red eyes, conjunctivitis, and anterior uveitis were frequently found in patients with Chikungunya fever. Other studies have described recurrent retinitis, congenital ocular symptoms, sepsis/septic shock, and renal manifestation, medulla spinalis supresi
Complications
Complications are rare and include uveitis, retinitis, myocarditis, hepatitis, nephritis, bullous skin lesions, hemorrhage, meningoencephalitis, myelitis, Guillain-Barré syndrome, and cranial nerve palsies
Some patients may experience relapse of rheumatic symptoms (eg, polyarthralgia, polyarthritis, or tenosynovitis) in the months following acute illness. It has been suggested that musculoskeletal complications are immune-mediated, and the presence of autoantibodies has been reported in infected patients with rheumatic symptoms
Neurologic complications including encephalitis, febrile seizures, and encephalopathies are common causes of hospitalization for pediatric patients with Chikungunya virus infection
Evaluation
RT-PCR is mainly used during acute infection, during the first five days of disease for best results
On the other hand, viral serology using enzyme-linked immunosorbent assay (ELISA) or indirect fluorescent antibody (IFA) is used for detection of anti-chikungunya antibodies IgM (present from five days to several weeks) and IgG (present from two weeks to several years), depending on the stage of disease.
The CDC and WHO recommend gathering serology for CHIKV, DENV, and Zika virus (ZV) for all patients with suspicious clinical symptoms
Defenisi
Demam chikungunya adalah jenis
penyakit menular dengan gejala utama demam mendadak, nyeri persendian terutama sendi lutut, pergelangan, jari kaki dan tangan serta tulang belakang yang disertai ruam (bintik-bintik kemerahan) pada kulit yang disebabkan oleh virus jenis Chikungunya, Genus Alphavirus, Famili Togaviridae
Chikungunya berasal dari bahasa Shawill yang menunjukkan gejala pada penderita dengan arti posisi tubuh meliuk atau melengkung, mengacu pada postur penderita yang membungkuk akibat nyeri sendi hebat (arthralgia).3 dan sumber lain menyebut berasal dari bahasa Makonde
yang artinya melengkung ke atas yang adalah merujuk pada tubuh bungkuk karena gejala arthritis penyakit ini
Prognosis
Most patients recover uneventfully
Mortality is rare and risk factors for death include older age
mekanisme transmisi
Demam chikungunya disebabkan oleh CHIK virus (CHIKV), virus ini ter masuk famili Alphavirus. Fakta sejarah
menyatakan bahwa virus chikungunya terjadi pertama di negara Afrika dan selanjutnya menyebar ke Asia
Transmisi penyakit Chikungunya di
Asia, terutama ditularkan oleh vektor nyamuk Aedes aegypti melalui siklus
transmisi orang ke orang di pemukiman padat penduduk (urban).
vektor chikungunya
Vektor yang berperan dalam penularan demam chikungunya adalah nyamuk Famili Culicidae Subfamili Culicidae, Genus Aedes, Spesies aegypti dan
albopictus
Nyamuk Aedes aegypti dan
Ae. albopictus mengalami metamorfosissempurna (holometabola), meliputi empat tahap yaitu telur, larva (jentik) pupa dan dewasa
dd chikungunya
arthralgia, high fever, and rash
Malaria
Yellow fever
Leptospirosis
Measles
Mononucleosis
African tick bite fever
Chronic arthralgia
Reiter arthritis
Rheumatoid arthritis
Systemic lLupus erythematosus
Seronegative rheumatoid arthritis
treatment
Symptomatic relief is the mainstay treatment for Chikungunya fever, including adequate hydration, rest, and pain/fever relief preferably with acetaminophen. WHO discourages the use of aspirin and most nonsteroidal anti-inflammatory drugs (NSAIDs) during the first 48 hours due to the risk of aggravating platelet dysfunction, especially in cases of possible DENV coinfection. Other studies advocate for the efficacy of low-dose corticosteroid drugs for the first 2 months of post-acute disease. Ocular manifestations including anterior and posterior uveitis have been treated with topical steroids and cycloplegics
Chronic manifestations, including persistent or relapsing-remitting polyarthralgia, polyarthritis, and myalgia, have been found to respond adequately to hydroxychloroquine in combination with corticosteroids or other disease modifying anti-rheumatic drugs (DMARDs / Disease modifying Anti Rheumatic Drugs).
Pathophysiologi demam & nyeri
patophysiologi
YUSMAWATI YUSRAN
SGD 12
1808260143
