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Duodenal perforation: A dreadful complication of Chikungunya fever.

Sundas Karimi, Umar Farooque, Rizwan Farooque.

Abstract
Chikungunya fever is a viral illness caused by chikungunya virus. It transmits through the bite of infected female Aedes mosquito during day time. Although it is not considered a contagious illness, but in rare cases, it can be transmitted through contact with an infected individual’s blood. The term” chikungunya” refers to both the virus (CHIKV) and the illness or fever (CHIKF) caused by this virus. Chikungunya virus is an Alpha virus that belongs to togaviridae family. It is a single- stranded RNA virus and is approximately 11.8 kb long with a capsid and a phospholipid envelope . It’s outbreaks are reported from Africa and South Asia. In 2017, one such outbreak was noted in Karachi, Pakistan. The symptoms of chikungunya fever are very much similar to those of other diseases like dengue fever. These usually appear just a few days after the mosquito bite. The most common symptoms are fever, sometimes as high as 1040F, joint pain, headache, muscle pain, rash and swelling around the joints. Rarely, symptoms can be accompanied by a maculopapular rash, conjunctivitis, nausea and vomiting. Blood serology can confirm the diagnosis. It is essential to rule out dengue fever. The virus is rarely fatal but the symptoms are very severe and disabling, specially joint pain which persists for months. The recommended treatment for chickungunya fever is aggressive hydration and paracetamol for pain. But even after the resolution of fever, joint pain persists long after due to which patients take non steroidal anti-inflammatory drugs, a potent analgesic prescribed by general practitioners. Non steroidal anti inflammatory drugs are the second most common risk factor for the development of peptic ulcer disease in the first part of duodenum and the top most risk factor for the development of peptic ulcer disease in stomach. Due to prolonged use of non steroidal anti-inflammatory drugs, patients develop peptic ulcer in the first part of duodenum. Peptic ulcer caused by NSAIDS can be treated with mucosal protective agents and proton pump inhibitors. If peptic ulcer remains untreated it can lead to dreadful complications like perforation of first part of duodenum. It presents with acute peritonitis that is a surgical emergency. Therefore, while treating chikungunya fever, the possibility of NSAIDS-induced ulcer should be kept in mind as this can lead to duodenal perforation months after chikungunya fever. For severe joint pain, physiotherapy should be encouraged as a possible treatment by health education programs. In this way, we can save patients from this complication.

Key words: Chikungunya fever, complications, peptic ulcer, duodenal perforation, NSAIDs,


 
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How to Cite this Article
Pubmed Style

Karimi S, Farooque U, Farooque R. Duodenal perforation: A dreadful complication of Chikungunya fever.. IJMSR. 2018; 1(2): 1-2.


Web Style

Karimi S, Farooque U, Farooque R. Duodenal perforation: A dreadful complication of Chikungunya fever.. http://www.ijmsronline.com/?mno=302643514 [Access: December 13, 2018].


AMA (American Medical Association) Style

Karimi S, Farooque U, Farooque R. Duodenal perforation: A dreadful complication of Chikungunya fever.. IJMSR. 2018; 1(2): 1-2.



Vancouver/ICMJE Style

Karimi S, Farooque U, Farooque R. Duodenal perforation: A dreadful complication of Chikungunya fever.. IJMSR. (2018), [cited December 13, 2018]; 1(2): 1-2.



Harvard Style

Karimi, S., Farooque, . U. & Farooque, . R. (2018) Duodenal perforation: A dreadful complication of Chikungunya fever.. IJMSR, 1 (2), 1-2.



Turabian Style

Karimi, Sundas, Umar Farooque, and Rizwan Farooque. 2018. Duodenal perforation: A dreadful complication of Chikungunya fever.. International Journal of Medical and Surgical Research, 1 (2), 1-2.



Chicago Style

Karimi, Sundas, Umar Farooque, and Rizwan Farooque. "Duodenal perforation: A dreadful complication of Chikungunya fever.." International Journal of Medical and Surgical Research 1 (2018), 1-2.



MLA (The Modern Language Association) Style

Karimi, Sundas, Umar Farooque, and Rizwan Farooque. "Duodenal perforation: A dreadful complication of Chikungunya fever.." International Journal of Medical and Surgical Research 1.2 (2018), 1-2. Print.



APA (American Psychological Association) Style

Karimi, S., Farooque, . U. & Farooque, . R. (2018) Duodenal perforation: A dreadful complication of Chikungunya fever.. International Journal of Medical and Surgical Research, 1 (2), 1-2.