Urological manifestations of Chikungunya fever: A single centre experience

Department of Urology, Muljibhai Patel Urological Hospital, Nadiad - 387 001, Gujarat, India.
Urology Annals 09/2010; 2(3):110-3. DOI: 10.4103/0974-7796.68859
Source: PubMed


Chikungunya is a viral infection often associated with lower urinary tract dysfunction. This study evaluates the urological squeal of Chikungunya fever in a single centre after an epidemic in 2006-2007 in India.
Retrospective analysis of medical records of 13 patients with lower urinary tract symptoms after Chikungunya fever was evaluated and outcome following intervention assessed.
A total of 13 patients (M:F=9:4), with age ranging from 30 to 72 years, were included in the study. They presented with chronic urinary retention (n=9, 69.23%) of which two had paraparesis, voiding symptoms alone (n=7, 53.8%), storage symptoms alone (n=3, 23%), and acute urinary retention (n=1, 7.6%). Presentation with lower urinary tract symptoms after an episode of Chikungunya fever was after a mean period of 163 days (range 30-360 days). Mean serum creatinine on presentation was 1.8 mg/dl (0.6-6.5 mg/dl). Evaluation revealed dilated upper tract in four (30.7%) patients. Cystometrography showed acontractile detrusor (n=3, 37.5%), hypocontractile detrusor (n=3, 37.5%), overactive detrusor (n=1, 12.5%) and normal study (n=1, 12.5%). At the mean follow up of 11 months, 11 patients (84.6%) had satisfactory functional outcome after intervention, namely supra pubic diversion and bladder training (n=5, 38.4%), alpha blocker (n=3, 23%), timed frequent voiding (n=2, 15.3%), clean intermittent catheterization (n=2, 15.3%), trial void with alpha blocker (n=1, 7.6%) while two are on continuing supra pubic diversion due to persistent neurological deficit.
Chikungunya fever is an uncommon entity in urological practice, often associated with urinary symptoms. An accurate assessment of the symptoms and timely intervention prevents upper tract deterioration and improves the quality of life.

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    ABSTRACT: Chikungunya fever (CF) is an acute illness caused by Chikungunya virus (CHIKV) belonging to the alphavirus genus of the Alphaviruses (Togaviridae) family. The virus is transmitted by Aedes mosquitoes. CF is primarily tropical disease occurring in Africa, Asia and Indian Ocean islands but in the last decade an outbreak of CHIKV autochthonous infections were reported in Italy and France. It is associated with viral genome mutations facilitating transmission of the disease by Aedes albopictus, a mosquito occurring in several European countries. The CF is highly symptomatic, characterized by fever, cutaneuos rash and severe athralgia and arthritis. In some patients severe neurological or hemorrhagic manifestations occur. The disease is self-limiting but a part of the patients suffers from a long-lasting arthritis akin to rheumatoid arthritis. Treatment is only symptomatic. Prevention includes reduction of mosquito bite (mosquito net, repellent) or application of measures against mosquito larvae. Vaccination is not currently available but investigations are in progress. CF presents a significant worldwide health problem affecting in the last decade millions of person, and currently dangerous also for European countries.
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