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Chikungunya Infection in Hospitalized Febrile Infants Younger Than 3 Months of Age.

Résumé : BACKGROUND: Fever in infants younger than 3 months is generally a cause for concern because of the risk for a serious bacterial infection. The aim of this study was to describe clinical and biological features of Chikungunya infection in infants < 3 months of age hospitalized in Cayenne Hospital during the 2014-2015 outbreak. METHODS: We performed a preliminary retrospective study followed by a prospective study from March 2014 to February 2015. All infants younger than 3 months presenting with fever and hospitalized in Cayenne Hospital were included. The main diagnostic criteria were fever and positive Chikungunya PCR. RESULTS: One hundred and twenty infants were hospitalized with fever. The mean age was 46 days (SD± 22 days). The mean hospitalization duration was 7.4 days (SD± 6.1 days). Chikungunya infection was diagnosed in 26 children. The most important clinical findings were high (80.8% [77.5-84]) and prolonged fever (76.9%, [73.4-80.4]), irritability (96.2% [94.5-97.7]) and skin rash. (69.2%, [65.4-73]). Half of the infants presented edema of the extremities (hands and feet principally). However, in 15 %, Chikungunya infection was associated with a serious bacterial infection. Infants who presented with irritability, high fever and elevated PCT were at high risk for Chikungunya: OR 39, [9.2-243] (p < 0.001), with a specificity of 96.7 % and a negative predictive value of 89.4%. The area of the ROC curve was 0.96 CONCLUSIONS:: Our results confirm that Chikunguyna infection is a cause of high fever in infants younger than 3 months. Our data should be confirmed by larger studies.
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https://www.hal.inserm.fr/inserm-01476019
Contributor : Inserm Cic1424 Centre d'Investigation Clinique Antilles Guyane <>
Submitted on : Friday, February 24, 2017 - 2:24:56 PM
Last modification on : Friday, October 23, 2020 - 4:37:21 PM

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Narcisse Elenga, Marion Folin, Yves-Marie Vandamme, Emma Cuadro-Alvarez, Laurence Long, et al.. Chikungunya Infection in Hospitalized Febrile Infants Younger Than 3 Months of Age.. Pediatric Infectious Disease Journal, Lippincott, Williams & Wilkins, 2017, Epub ahead of print. ⟨10.1097/INF.0000000000001541⟩. ⟨inserm-01476019⟩

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