Volume 24, Number 9—September 2018
Dispatch
Severe Manifestations of Chikungunya Fever in Children, India, 2016
Table
Parameters | Nonsevere disease, n = 36 | Severe disease, n = 13 | p value† |
---|---|---|---|
Median age, y (range) | 6.5 (0.75–15) | 12 (0.5–14) | 0.28 |
Male:female ratio |
3.5:1 |
2.25:1 |
0.53 |
Age group | |||
Infant, 1 mo–1 y | 3 (8.3) | 4 (30.7) | 0.06 |
Toddler, 2–5 y | 13 (36) | 1 (7.7) | |
School age, 6–12 y | 3 (8.3) | 0 | |
Adolescent, 13 to <18 y |
17 (47.2) |
8 (61.5) |
|
Clinical profile | |||
Fever | 36 (100) | 13 (100) | |
Body ache | 10 (27.7) | 4 (30.7) | 0.83 |
Rash | 15 (41.6) | 8 (61.5) | 0.22 |
Arthralgia | 5 (13.9) | 3 (23) | 0.44 |
Vomiting | 15 (41.6) | 5 (38.4) | 0.84 |
Seizures | 11 (30.5) | 1 (7.7) | 0.14 |
Bleeding | 3 (8.3) | 4 (30.7) | 0.16 |
Abdominal pain | 4 (11) | 5 (38.4) | 0.25 |
Peripheral cyanosis and mottling of skin | 2 (5.5) | 10 (76.9) | 0.00 |
Encephalopathy |
0 |
3 (23) |
0.01 |
Laboratory test results, median (range) | |||
Hemoglobin, g/dL | 12.2 (6.6–17.5) | 11.6 (8–13.5) | 0.08 |
White cell count/µL | 8,195 (3,700–15,200) | 11,200 (4,100–44,800) | 0.058 |
Platelet count, × 103/µL) | 203 (25–362) | 192 (13–362) | 0.61 |
AST, IU/L | 44 (22–174) | 43 (16–8,837) | 0.96 |
ALT, IU/L | 20 (9–96) | 24 (8–2,311) | 0.26 |
Albumin | 3.75 (3.5–4) | 3.3 (1.6–3.5) | 0.006 |
Urea, mg/dL | 21 (11–55) | 36 (13–87) | 0.094 |
Creatinine, mg/dL | 0.4 (0.3–1.2) | 0.6 (0.2–1.3) | 0.37 |
APTT, s, control 28.4 s | NA | 41.7 (27–247) | |
PT, s, control 13.3 s | NA | 22.3 (18.5–117) | |
International normalized ratio |
NA |
1.77 (1.3–12.4) |
|
Organ dysfunction | |||
Cardiovascular | 0 | 11 (84.6) | |
Respiratory | 0 | 3 (23) | |
Hematological | 0 | 5 (38.4) | |
Neurologic | 0 | 3 (23) | |
Renal | 0 | 2 (15.3) | |
Hepatic |
0 |
3 (23) |
|
Course and outcome | |||
Mechanical ventilation | 0 | 3 (23) | |
Inotropic support | 0 | 11 (84.6) | |
Renal replacement | 0 | 2 (15.3) | |
Hospital stay, d (range) | 3 (2–7) | 5 (2–13) | 0.0015 |
Death | 0 | 1 (7.7) |
*Values are no. (%) patients except as indicated. ALT, alaninine aminotransferase; APTT, activated partial thromboplastin time; AST, aspartate aminotransferase; NA, not applicable; PT, prothrombin time.
†Categorical variables were compared using the χ2 test or Fisher exact test, as appropriate, and continuous variables were compared by using the nonparametric Mann-Whitney test. p values <0.05 were considered statistically significant and are shown in bold type.
Page created: August 15, 2018
Page updated: August 15, 2018
Page reviewed: August 15, 2018
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