Brucellosis physical examination

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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.[1] Common physical examination findings include hepatomegaly, splenomegaly, and lymphadenopathy.[2]

Physical Examination

Appearance of the Patient

  • Patients are usually well-appearing[1]

Neck

  • Cervical lymphadenopathy

Lungs

  • Increased tactile fremitus
  • Dullness on percussion
  • Decreased breath sounds
  • Bronchial breath sounds
  • Rhonchi
  • Crackles, Rales
  • Increased vocal fremitus
    • May be present in lobar pneumonia

Heart

  • Heart murmurs
    • May be present in infective endocarditis

Abdomen

  • Hepatomegaly
  • Splenomegaly
  • Lymphadenopaty

Genitourinary

  • Inguinal lymphadenopathy
  • Positive Prehn's sign
    • May be present in epididymitis
  • Swollen testicle or testicles
    • May be present in orchitis

Extremities

  • Knee, hips, ankles and wrists:
    • Fluid around a joint
    • Warm, red, tender joints
    • Difficulty moving a joint (called "limited range of motion")
    • May be present in peripheral arthritis
  • Pain around sacroiliac joints
    • May be present in sacroiliitis
  • Positive Schober test
    • May be present in spondilitis

Neuromuscular

  • Nuchal rigidity
  • Kernig's sign
  • Brudzinski's signs
    • May be present in meningitis[2]

Reference

  1. 1.0 1.1 Madkour M. Madkour's Brucellosis. Springer Science & Business Media; 2012.
  2. 2.0 2.1 Pappas G, Akritidis N, Bosilkovski M, Tsianos E (2005). "Brucellosis". N Engl J Med. 352 (22): 2325–36. doi:10.1056/NEJMra050570. PMID 15930423.

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