デング？チングニア？それとも…

問診で落ちやすいのは、渡航歴、動物曝露歴、性的なコンタクト歴。

似たような状況、症状、最後に決着をつけるための検査。

しかし。タイミングによって結果もかわります。さてどうする、です。

Differentiating Chikungunya From Dengue: A Clinical Challenge

"Test results were returned several days later and were positive for detection of anti-dengue virus (DENV) IgG antibodies but were negative for detection of anti-DENV IgM antibodies. Testing was also negative for anti-chikungunya virus (CHIKV) IgM and IgG antibodies. The patient was diagnosed with dengue and a report was made to the local health department."


しかし、三週間後。

"Three weeks later the patient returned, complaining of persistent joint pain in her hands and feet. "

"Repeat dengue and chikungunya serologic diagnostic testing was requested and was positive for detection of anti-CHIKV IgM and IgG antibodies; both anti-DENV IgM and IgG antibodies were negative.

The patient was referred to a rheumatologist for consultation regarding pain management."

うーん。来週のドクターGくらい難しい。