1. Parsonage-Turner syndrome following chikungunya virus infection: A case report
Luis Arthur Brasil Gadelha FARIAS ; Roberto Da Justa PIRES NETO ; Jorge Luiz Nobre RODRIGUES ; Marina Vasconcelos SAMPAIO ; Antônio Carlos Delgado SAMPAIO ; Roberto Da Justa PIRES NETO ; Jorge Luiz Nobre RODRIGUES
Asian Pacific Journal of Tropical Medicine 2019;12(5):239-243
Rationale: Parsonage-Turner syndrome is a rare syndrome of unknown etiology, affecting mainly the lower motor neurons of the brachial plexus. Chikungunya fever is a mosquito-borne viral disease characterized by acute fever and polyarthritis/polyarthralgia. Patient concerns: A 54-year-old Brazilian male patient who presented with a 2-day history of fever (temperature 38.8 °C), arthralgia, erythematous rash, diffuse osteomuscular pain and headache, which evolved into left shoulder pain associated with morning stiffness. Diagnosis: Parsonage-Turner syndrome and chikungunya fever. Interventions: Symptomatic treatment (a combination of short-acting dypirone (500 mg every 6 h) and slow-release opioids (tramadol 100 mg every 4 h) and physiotherapy/rehabilitation with improvement. Outcomes: The patient was improved and discharged, remaining with symptomatic treatment and physiotherapy/rehabilitation. Lessons: To the best of our knowledge, there were no reports of Parsonage-Turner syndrome following chikungunya virus infection. Awareness of the possibility of this rare association is important. The present case report highlights the importance of awareness of this association as a new cause of morbidity in patients with chikungunya virus infection.
2. Clinical outcomes of hospitalized patients with chikungunya fever: A retrospective analysis
Lucas Lobo MESQUITA ; Enio Simas MACEDO ; Sérgio Luiz Arruda Parente FILHO ; Francisca Lillyan Christyan Nunes BESERRA ; Evelyne Santana GIRAO ; Juliana Mandato FERRAGUT ; Roberto Da Justa Pires NETO ; Geraldo Bezerra DA SILVA JÚNIOR ; Elizabeth DE FRANCESCO DAHER
Asian Pacific Journal of Tropical Medicine 2021;14(4):183-186
Objective: To describe the prognostic and clinical profile of hospitalized patients with chikungunya virus (CHIKV) infection focusing on renal outcomes. Methods: This is a cross-sectional study including all patients with confirmed chikungunya fever (CHIKF) admitted to 3 different high-complexity hospitals in Fortaleza, Brazil between January 2016 and June 2017. Data analysis was carried out to evaluate correlation between clinical profile and outcomes. Results: Fifty-five patients were included, with a median age of 77 (IQR=21) years, and 23 (41.82%) were male. Twenty-five patients (45.45%, 25/55) developed acute kidney injury (AKI), and 15 (60.00%, 15/25) were classified as KDIGO 1, 1 (4.00%) as KDIGO 2, and 9 (36.00%) as KDIGO 3. The overall mortality was 34.54% whilst AKI-related mortality was 64.00% (16/25). Both AKI and encephalitis were associated with higher mortality. Patients who died were significantly older [82 (IQR=12) years vs. 70 (IQR= 28.75) years, P<0.001)]. In the multivariate analysis, abdominal pain was associated with an increased risk of severe AKI (OR=5.33, 95% CI=1.11-25.64, P=0.037) and AKI was an independent risk factor of death (OR=12.06, 95% CI=2.55-57.15, P=0.002). Recovery of renal function was similar among the different age groups. Conclusions: AKI is present in half of the study population and is an independent risk factor of death. Thus, renal function should be carefully monitored in hospitalized patients with CHIKV infection.