Cytomegalovirus infection physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
Overview
Physical Examination
General Appearance of the patient
The appearance of the patient depends on the stage of the disease. The patient may look very healthy or be ill-looking and cachectic.
Vitals
Temperature
- Fever can be present.
Pulse
- Tachycardia can be present.
Blood pressure
- Hypotension can be present.
Respiratory rate
- Tachypnea can be seen during fever and respiratory tract infections
HEENT
Eyes On fundus examination the following findings can be demonstrated in patients with CMV retinitis:
- Fluffy yellow-white retinal lesions, with or without intraretinal hemorrhage.
- Inflammation of the vitreous can be demonstrated in patients with severe immunosuppression.
- Blood vessels appear sheathed.
- If left untreated, retinitis is a rapidly progressive condition and on fundus examination it demonstrates a characteristic brushfire pattern, with a granular, white leading edge advancing before an atrophic gliotic scar.
Cardiovascular
- Normal heart sounds
- No murmurs, gallops or rubs
Lungs
Abdomen
- Abdominal tenderness
- Abdominal distension can be present on examination in patients with CMV colitis.
Extremities
- Muscle weakness may be present.
Central Nervous System
The following examination findings can be present in CMV encephalitis:
- Focal neurological deficits
- Altered mental status
- Hypotonia
- Normal or diminished deep tendon reflexes