Esophageal candidiasis physical examination

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

Overview

Examination reveals signs of immunocompromisation that was the primary cause of developing esophageal thrush.

Physical Examination

Appearance of the patient

• Patients with esophageal candidiasis are usually ill-appearing.
• They may later become apathetic and delirious.

Vital Signs

Temperature

• Hyperthermia (temperatures as high as 42° C) is a sign of infection and hypothermia (temperatures as low as 35° C) indicates septic shock.
• Hypothermia is a grave sign,seen late in the course of the disease in patients with on-going fungaemia or septic shock.

Blood Pressure

• The blood pressure is maintained within normal limits early in the disease process but as fungemia progresses, the blood pressure decreases due to shock

Pulse

• Tachycardia with weak, thready peripheral pulses represents decreased effective circulating blood volume, indicating a stage of shock later in the disease.
• May be normal or increased in rate due to infection.
• It may be low in volume due to dehydration.

Respiration

• Tachypnea due to infection and increased oxygen demand.

Skin

• Opportunistic skin conditions as Folliculitis, Kaposi sarcoma, skin candidiasis.
• HIV associated conditions may be present as Seborrheic dermatitis and Psoriasis.

Eyes

• Retinal haemorrhage and retinal infiltrates may be present.

Head

• Tenderness of sinuses may be elicited.

Nose

• Inflammation of the nasal turbinates may be present.

Ears

• Unilateral or bilateral deafness may be present.
• Discharge from the ears may be found.

Throat

• Peridontal disease may be present.
• Oral herpes and Oral thrush simplex lesions may be found.

Lungs

• Crackles and rhonchi may be found.
• Dullness to percussion can be present.
• Increased tactile fremitus can be present.

Cardiovascular system

• A heart murmur can be found.

Abdomen

• Abdominal tenderness can be found.
• Hepatomegaly and splenomegaly may be detected.

Genitourinary

• Vaginal or urethral discharge can be present.

Extremities

• Muscle weakness and joint swelling may be present.

Central Nervous System

• Focal neurological deficits may be found.

• Behavioral changes may be observed.
• Gait disturbances may be present.