Poster Discussion Abstracts
Aims & Objectives:
Analysis of spectrum of critical illness in patients of Chikungunya fever
Design: Cross sectional observational study of children with chikungunya fever admitted in a tertiary care hospital (Artemis health institute, Gurgaon) in north India in year 2015–2016
Setting and participants: Analysis of disease spectrum in 57 RT-PCR positive cases of chikungunya fever aged 0–16 yrs, admitted in Artemis health institute. 12 (21%) patients required PICU care while 9 (15.7%) children monitored in HDU & rest 36 (63.1%) patient were managed in ward.
In all laboratory confirmed RT-PCR positive 57 patient with chikungunya infection, high grade fever was invariably present. Most striking observation was hemodynamic dysfunction as hypotensive shock in 14 patients(28%) with blood pressure being less than 5th centile for age, along with tachycardia and raised blood lactate levels (>2 mmoll/l). Four children responded to fluid resuscitation and didn’t require vasopressor support. Ten patients(17.5%), mainly with warm shock, needed fluid resuscitation along with vasopressors- mainly noradrenaline. Average duration of vasopressor support was 21 hrs (12–60 hrs). Dengue serology was negative in all. Eight patients (14%) had seizures; five were diagnosed as febrile seizure and three were diagnosed and managed as meningoencephalitis. 12(21%) children had GCS between 11 and 13. There was no mortality.
Resurgence of chikungunya since 2006 with change in genotype and mutation in genome of viruses has changed the clinical scenario. Occurrences of life threatening dysfunctions in debilitating chikungunya infection require intense clinical supervision and management.