Docs spot atypical symptoms in chikungunya patients

Pune: From mild to short-term fevers to chickenpox-like fluid-filled boils, chikungunya patients have reported a range of atypical or unusual symptoms this year, doctors in the city have said.
There were patients with more persistent pain in the joints, which orthopedic specialists said was indeed uncommon.
Dr Abhijit Agashe, an orthopedic and joint replacement surgeon at Sahyadri Hospital, said: "In earlier outbreaks, patients typically had high fever followed by joint pain.But this time, I've seen several cases with only mild fever lasting a day or two. This shift in symptoms is confusing, with patients often mistaking the infection for orthopedic issues. This is also why many first approached orthopedic clinics instead of GPs."
Dr Agashe said some chikungunya patients also had pain not limited to their joints. "Earlier, we'd see pain only in the joints. But this year, patients have had widespread body ache, including back pain, which is different from localised joint pain."
He said recovery times have also extended. "Patients would find some relief within a few weeks of medication. But this year, we've seen a more persistent illness. People are not feeling better despite 20 to 21 days of medication," Dr Agashe said, adding that even after three weeks, symptoms such as back pain and redness and swelling of the foot persisted.
He said a significant number of patients also had small white patches, resembling mustard seeds, after infection resolved. "While this has happened before, this condition is now very widespread," he said.
Dr Amita Kaul, head of paediatrics at Surya Mother and Child Super Speciality Hospital, said: "Chikungunya incidence this year is much higher, with patients showing rashes we have not seen before. For instance, one type of rash resembles chickenpox, with fluid-filled spots. We're also observing brown pigmentation on the nose in adults and around the mouth, forcing some people to wear masks to hide these manifestations."
She said some children developed a brownish discoloration on their faces due to this "post-infection pigmentation issue".
Recounting other unusual symptoms, Dr Kaul added: "Typically, infections such as chikungunya and dengue do not cause respiratory symptoms. They are more characteristic of infections like H1N1 and Covid. However, we recently had a child who had fever and respiratory symptoms. A PCR test confirmed chikungunya."
While some patients experienced short-duration fever as reported by other doctors, Dr Kaul said several children with chikungunya had prolonged fever that persisted for days. "In such cases, when the duration of fever is so extended, doctors need to carry out more tests to rule out other serious conditions such as cancer or autoimmune disorders," she said.
Dr Raghav Barve, senior orthopedics and joint replacement surgeon at Ruby Hall Clinic, said: "This year, we're seeing patients with severe swelling and joint pain that lasts longer. Some patients required painkillers for months. Earlier, pain resolution would begin within two weeks. Now, it's taking three to four weeks or more."
Dr Aniket Patil, a specialist in joint replacement and arthroscopic surgery at Noble Hospital, said he's had several patients this year with just a day of fever and immediate full body pain, instead of localised joint pain that's more typical of chikungunya.