Chikungunya physical examination

Chikungunya usually presents with clinical signs such as fever, skin rashes, and joint swelling with effusions that can be detected during a physical examination.

The disease is characterized by an acute onset of high fever, typically more than 39°C (102°F).

• Maculopapular rash
• Nasal blotchy erythema
• Freckle-like pigmentation over centro-facial area
• Flagellate pigmentation on face and extremities
• Lichenoid eruption and hyperpigmentation in photodistributed areas
• Multiple aphthous-like ulcers over scrotum, crural areas and axilla.
• Lymphedema in acral distribution (bilateral/unilateral)
• Multiple ecchymotic spots (children)
• Vesiculobullous lesions (infants)
• Subungual hemorrhage
• Photo urticaria
• Acral urticaria

• Polyarthralgia usually symmetric and often occur in hands and feet
• Periarticular swelling and joint effusion in knees.

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  Edematous rash of the face
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  Edematous polyarthritis of the hands
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  Erythema that blanches with pressure
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  Periarticular swelling and joint effusion in knees
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  Joint effusion in right knee
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  Arthritis in left hand
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  Maculopapular rash in trunk and extremities
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  Maculopapular rash in extremities, including palms
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  Bullous lesions in infant leg
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  Infant with maculopapular rash, petechial spots and erythema of upper and lower limbs associated with edema of the extremities
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  Maculopapular rash in the trunk
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  Maculopapular rash in the feet

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  End of the acute stage. Swollen hands and fine desquamation
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  Hyperpigmentation
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  Tenosynovitis in hands
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  Tenosynovitis in ankle
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  Elbow hygroma
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  Swollen and stiff hands in a 55-year-old man who was infected 5 years earlier

• CDC Chikungunya virus