Brucellosis physical examination: Difference between revisions

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==Overview==
==Overview==
Patients with brucellosis are usually well-appearing.<ref name="aa">Madkour M. Madkour's Brucellosis. Springer Science & Business Media; 2012.</ref> Common physical examination findings include [[hepatomegaly]], [[splenomegaly]], and [[lymphadenopathy]].<ref name="pmid15930423">{{cite journal| author=Pappas G, Akritidis N, Bosilkovski M, Tsianos E| title=Brucellosis. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 22 | pages= 2325-36 | pmid=15930423 | doi=10.1056/NEJMra050570 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15930423  }} </ref>
Patients with brucellosis are usually well-appearing. Physical examination findings usually reveal combination of  several non-specific findings.  


==Physical Examination==
==Physical Examination==
Patients with brucellosis are usually well-appearing. Physical examination usually reveal combination of several non-specific findings, which include:<ref name="aa">Madkour M. Madkour's Brucellosis. Springer Science & Business Media; 2012.</ref><sup>[[Brucellosis history and symptoms|[2][3][4][5][6][7][8][9][10][11]]]</sup>
{| class="wikitable"
{| class="wikitable"
!Examination findings
!Examination findings
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Blood pressure- Normal
Blood pressure- Normal


Respiratory rate-Normal/tachypnea(pneumonia)
Respiratory rate-Normal/tachypnea(pneumonia/lung involvement)


[[Oxygen saturation]]- usually normal but some cases may have low oxygen saturation(lung involvement).
[[Oxygen saturation]]- usually normal but some cases may have low oxygen saturation(lung involvement).
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|[[Skin]]
|[[Skin]]
|Skin examination may reveal the following:
|Skin examination may reveal the following:
Maculppapular rash
* Maculppapular rash
 
* Erythema nodosum like eruptions and ulceration
Erythema nodosum like eruptions and ulceration
* abscesses
 
abscesses
|-
|-
|HEENT
|HEENT
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|-
|-
|Neck
|Neck
|Cervical [[lymphadenopathy]] may be present
|Neck examination is usually normal but cervical [[lymphadenopathy]] may be present in few patients
|-
|-
|[[Lungs]]
|[[Lungs]]
|Lung involvement may reveal multiple findings depending on the kind of involvement(it could be pneumonia, bronchitis, pleural effusion or empyema or combination of these). Based on the involvement, lung examination may reveal:
|Brucellosis involving lung, may reveal multiple findings depending on the kind of involvement(it could be pneumonia, bronchitis, pleural effusion or empyema or combination of these). Based on the involvement, lung examination may reveal:
*Increased [[tactile fremitus]]
*Increased [[tactile fremitus]]
*Dullness on [[Percussion of the lungs|percussion]]
*Dullness on [[Percussion of the lungs|percussion]]
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|-
|-
|[[Heart]]
|[[Heart]]
|Cardiovascular examination may reveal murmurs on ascultation(endocarditis)
|Brucellosis involving heart may reveal murmurs on ascultation(endocarditis)
|-
|-
|[[Abdomen]]
|[[Abdomen]]
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|Meningial signs of irritation  [[Nuchal rigidity]], [[Kernig's sign]], and [[Brudzinski's sign]] can be ilicited in cases with neurological involvement(meningitis or meningoencephalitis).
|Meningial signs of irritation  [[Nuchal rigidity]], [[Kernig's sign]], and [[Brudzinski's sign]] can be ilicited in cases with neurological involvement(meningitis or meningoencephalitis).


Signs of pheripheral and cranial nerve neuropathies can be ilicited
Signs of neuropathies of individual pheripheral and cranial nerve can be ilicited
|}
|}
*
*

Revision as of 18:41, 6 January 2017

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

Overview

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

Physical Examination

Patients with brucellosis are usually well-appearing. Physical examination usually reveal combination of several non-specific findings, which include:[1][2][3][4][5][6][7][8][9][10][11]

Examination findings Brucellosis
Appearance of patient Patients are usually well-appearing
Vital Signs Pulse rate-Normal/Tachycardia with regular rhythm, normal volume

Temperature- Normal or elevated

Blood pressure- Normal

Respiratory rate-Normal/tachypnea(pneumonia/lung involvement)

Oxygen saturation- usually normal but some cases may have low oxygen saturation(lung involvement).

Blood glucose level- normal

Skin Skin examination may reveal the following:
  • Maculppapular rash
  • Erythema nodosum like eruptions and ulceration
  • abscesses
HEENT Eye examination is usually normal but signs of Uveitis may be elicit in few patients
Neck Neck examination is usually normal but cervical lymphadenopathy may be present in few patients
Lungs Brucellosis involving lung, may reveal multiple findings depending on the kind of involvement(it could be pneumonia, bronchitis, pleural effusion or empyema or combination of these). Based on the involvement, lung examination may reveal:
Heart Brucellosis involving heart may reveal murmurs on ascultation(endocarditis)
Abdomen Abdominal examination may elicit:
  • Tenderness
Back Back examination is usually normal
Genitourinary Genitourinary examination may reveal:
Extremities
  • Examination of Knee, hips, ankles and wrists may reveal:
    • Fluid around a joint
    • Warm, red, tender joints
    • Difficulty moving a joint (called "limited range of motion")
    • May be present in peripheral arthritis
  • palpation of sacroiliac joints may reveal pain indicating sacroiliitis
  • Positive Schober's test(indicative of spondylitis)
Neuromuscular Meningial signs of irritation Nuchal rigidity, Kernig's sign, and Brudzinski's sign can be ilicited in cases with neurological involvement(meningitis or meningoencephalitis).

Signs of neuropathies of individual pheripheral and cranial nerve can be ilicited

Reference

  1. Madkour M. Madkour's Brucellosis. Springer Science & Business Media; 2012.