Actinomycosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Patients with actinomycosis are usually well-appearing. Physical examination reveals combination of several non-specific findings.

Physical Examination

The physical examination findings of actinomycosis are are mostly nonspecific and are described according to the organ involved

Vital Signs

• Fever
• Tachypnea

Oral cavity

• Oral ulcers can be seen in some patients
• Poor dental hygiene with dental caries
• Trismus

Lymph nodes

• In cases with skin involvement from direct inoculation, regional lymph node enlargement may be seen.

Neck

• No masses
• Suppurative abscesses with fistula tracts or draining sinuses

Cardiovascular system

• Regular rate and rhythm
• Normal S1, S2
• No murmurs, rubs, or gallops

Lungs

Findings consistent with parenchymal consolidation such as

• Dullness to percussion
• Increased fremitus
• Signs of pleura involvement such as pleuritic rub.

Abdominal

• A palpable mass can be present in any quadrant of abdomen.
• Most common in right lower quadrant( ileocecal valve) due to its association with appendicitis.

Skin

• Nodular lesions which gradually increase in size and number resulting in multiple abscesses, and ultimately forming sinuses that open outside.
• Skin around the abscess appears swollen, erythematous, or ecchymotic

Genitourinary system

• Pyuria
• Painful urination
• Pelvic mass
• Menometrorrhagia

Extremities

• Ulcers that bleed on touch

Nervous system examination

• Stiff neck
• Photophobia

References

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