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Serious acute chikungunya virus infection requiring intensive care during the Reunion Island outbreak in 2005-2006.
Crit Care Med. 2008 Sep; 36(9):2536-41.CC

Abstract

OBJECTIVE

To report the clinical and laboratory findings of adults with serious chikungunya virus acute infection hospitalized in an intensive care unit.

DESIGN

Case series study from August 2005 to May 2006.

SETTING

Medical intensive care unit, South Reunion Hospital.

PATIENTS

We observed 33 episodes of confirmed acute chikungunya virus infection (chikungunya virus-IgM or reverse transcription-polymerase chain reaction positive in the serum) admitted to the intensive care unit.

INTERVENTIONS

We collected cerebrospinal fluid, serum, and sometimes tissue samples from patients with suspected chikungunya fever in our intensive care unit. These samples underwent viral testing for evidence of acute chikungunya virus infection.

MEASUREMENTS AND MAIN RESULTS

Of the 33 patients, 19 (58%) had chikungunya virus specific manifestations, 8 (24%) had associated acute infectious disease and 6 (18%) exacerbations of previous complaints. Among the chikungunya virus specific manifestations, we identified 14 cases of encephalopathy, one case each of myocarditis, hepatitis and Guillain Barré syndrome. Eighty-five percent of patients had a McCabe score = 1 (for nonfatal or no underlying disease). Mortality was 48%.

CONCLUSIONS

Chikungunya virus infection may be responsible for very severe clinical presentation, including young patients with unremarkable medical histories. Chikungunya virus infection is strongly suspected to have neurologic, hepatic, and myocardial tropism leading to dramatic complications and high mortality rate.

Authors+Show Affiliations

Department of Medical Intensive Care, South Hospital, Saint-Pierre, Reunion, France. jerome.lemant@orange.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18679124

Citation

Lemant, Jérôme, et al. "Serious Acute Chikungunya Virus Infection Requiring Intensive Care During the Reunion Island Outbreak in 2005-2006." Critical Care Medicine, vol. 36, no. 9, 2008, pp. 2536-41.
Lemant J, Boisson V, Winer A, et al. Serious acute chikungunya virus infection requiring intensive care during the Reunion Island outbreak in 2005-2006. Crit Care Med. 2008;36(9):2536-41.
Lemant, J., Boisson, V., Winer, A., Thibault, L., André, H., Tixier, F., Lemercier, M., Antok, E., Cresta, M. P., Grivard, P., Besnard, M., Rollot, O., Favier, F., Huerre, M., Campinos, J. L., & Michault, A. (2008). Serious acute chikungunya virus infection requiring intensive care during the Reunion Island outbreak in 2005-2006. Critical Care Medicine, 36(9), 2536-41. https://doi.org/10.1097/CCM.0b013e318183f2d2
Lemant J, et al. Serious Acute Chikungunya Virus Infection Requiring Intensive Care During the Reunion Island Outbreak in 2005-2006. Crit Care Med. 2008;36(9):2536-41. PubMed PMID: 18679124.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serious acute chikungunya virus infection requiring intensive care during the Reunion Island outbreak in 2005-2006. AU - Lemant,Jérôme, AU - Boisson,Véronique, AU - Winer,Arnaud, AU - Thibault,Laure, AU - André,Hélène, AU - Tixier,François, AU - Lemercier,Marie, AU - Antok,Emmanuel, AU - Cresta,Marie Pierre, AU - Grivard,Philippe, AU - Besnard,Mathieu, AU - Rollot,Olivier, AU - Favier,François, AU - Huerre,Michel, AU - Campinos,José L, AU - Michault,Alain, PY - 2008/8/6/pubmed PY - 2008/10/3/medline PY - 2008/8/6/entrez SP - 2536 EP - 41 JF - Critical care medicine JO - Crit Care Med VL - 36 IS - 9 N2 - OBJECTIVE: To report the clinical and laboratory findings of adults with serious chikungunya virus acute infection hospitalized in an intensive care unit. DESIGN: Case series study from August 2005 to May 2006. SETTING: Medical intensive care unit, South Reunion Hospital. PATIENTS: We observed 33 episodes of confirmed acute chikungunya virus infection (chikungunya virus-IgM or reverse transcription-polymerase chain reaction positive in the serum) admitted to the intensive care unit. INTERVENTIONS: We collected cerebrospinal fluid, serum, and sometimes tissue samples from patients with suspected chikungunya fever in our intensive care unit. These samples underwent viral testing for evidence of acute chikungunya virus infection. MEASUREMENTS AND MAIN RESULTS: Of the 33 patients, 19 (58%) had chikungunya virus specific manifestations, 8 (24%) had associated acute infectious disease and 6 (18%) exacerbations of previous complaints. Among the chikungunya virus specific manifestations, we identified 14 cases of encephalopathy, one case each of myocarditis, hepatitis and Guillain Barré syndrome. Eighty-five percent of patients had a McCabe score = 1 (for nonfatal or no underlying disease). Mortality was 48%. CONCLUSIONS: Chikungunya virus infection may be responsible for very severe clinical presentation, including young patients with unremarkable medical histories. Chikungunya virus infection is strongly suspected to have neurologic, hepatic, and myocardial tropism leading to dramatic complications and high mortality rate. SN - 1530-0293 UR - https://www.unboundmedicine.com/medline/citation/18679124/Serious_acute_chikungunya_virus_infection_requiring_intensive_care_during_the_Reunion_Island_outbreak_in_2005_2006_ L2 - https://dx.doi.org/10.1097/CCM.0b013e318183f2d2 DB - PRIME DP - Unbound Medicine ER -