Case Report on Zika
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Zika, physical therapy, joint pain, Guatemala
Kayla Limbert and Abigail Anderson
Young active female presents to physical therapy clinic upon return from Guatemala with complaints of bilateral knee joint pain and muscle aches. Pt does not have any pertinent past medical history. Objective findings included fever, mosquito bites, and decreased movement due to pain. Pt was referred on to physician for further diagnostic testing for underlying systemic cause.
This case presents a relatively healthy individual with insidious onset of bilateral joint pain. Physical therapists can play a role in differentiate between musculoskeletal symptoms and systemic symptoms for patient’s history and clinical findings.
• Subjective: Pt is a 25 y/o female presenting to clinic with joint pain in her knees. She also complains of muscle pain in her lower extremities. Pt stated pain started two days after she returned to the United States from Guatemala. She did not have any pain previous and does not remember doing anything that would hurt it. Pt also complained of a headache and feeling under the weather.
• Relevant Medical Hx: No previous LE joint pain, Headache, Sickness feeling
• Demographic Information: Female, artist, active, normal weight
• Co-morbidities: None
• Previous care or treatment: Patient took Tylenol for pain in her knees.
• Self Report Outcome Measures: VAS 5/10
• Objective : Physical Examination Tests and Measures
o Patient presented with flexed position at bilateral knees in weight bearing
o ROM WNL with the exception of decreased knee extension due to pain
o MMT normal but pt c/o of muscles aching in B quads and gastrocnemius
o Sensation and reflexes WNL
o Antalgic Gait
o Mosquito bites present on arms and legs
Based upon findings, patient would be referred to a physician for further diagnostic testing to rule out a systemic disease due to fever, headache, and bilateral joint pain/muscle aches. Suspicious finding were multiple mosquito bites on arms and legs. Pt most likely has Zika based upon her gender, recent travel history, and symptoms.
• Phase 1: Protect body and joints /education
o Rest and Ice
o Avoid Exertion to worsen symptoms
o Education of ways of transmission and risk (sexual activity, travel)
o Progress to normal daily activities as symptoms of disease subsides
Zika virus does not permanently stay in the body. After a few weeks, the immune system will recover and symptoms will subside. Pt will have an excellent outcome and can recover with medical management and education. Further complications would occur if person was pregnant at time of infection of if they get pregnant 2 years after infection.
Physical therapists can play a role in differential diagnosis of a systemic disease presenting a musculoskeletal. PT can also educate patients on the effects of Zika as well as provide treatment to decrease their pain and increase function.
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