Ebola physical examination: Difference between revisions
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====Blood Pressure==== | ====Blood Pressure==== | ||
* [[Hypotension]] (less than 90 mm Hg of [[Blood pressure|SBP]] and 60 mm Hg of [[DBP]]) | * [[Hypotension]] (less than 90 mm Hg of [[Blood pressure|SBP]] and 60 mm Hg of [[DBP]]) is typically present | ||
* [[Postural hypotension]] may be present | * [[Postural hypotension]] may be present | ||
Revision as of 16:16, 15 July 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Guillermo Rodriguez Nava, M.D. [2]; João André Alves Silva, M.D. [3]
Overview
Ebola is commonly associated with the acute onset of high fever, chills and hemorrhage as well as swollen joints, weakness, rash and red eyes.[1][2][3]
Physical Examination
Appearance of the Patient
The general appearance of the patient will depend on the stage of the disease. Common presentations include a patient who shows prostration, who may be nauseated and vomiting, with shortness of breath and dysphagia and possibly showing some kind of hemorrhage, most typically retinal and/or bleeding gums. In later stages of the disease, the patient might present with convulsions or be in shock.[4]
Vitals
Temperature
- High fever is often present
Pulse
Rate
- Tachycardia is often present
Rhythm
- The pulse is often regular
Strength
- The pulse may be weak, in cases of dehydration and hemorrhage
Symmetry
- The pulses are often symmetric
Blood Pressure
- Hypotension (less than 90 mm Hg of SBP and 60 mm Hg of DBP) is typically present
- Postural hypotension may be present
Respiratory Rate
- Signs of respiratory difficulty may be present, such as:
- Intercostal retractions
- Paradoxical breathing
- Nasal flare
- Tachypnea - it is important to notice that many fatal cases presented with tachypnea and that none of the survivors showed signs of tachypnea
Skin
Hemorrhagic manifestations tend to occur on more severe stages of the disease and may include:[1]
- Maculopapular rash on the trunk, usually between the 5th and 7th day of the condition, associated with different stages of erythema and desquamation, which is a valuable finding for the differential diagnosis
- Petechiae is a common finding
- Ecchymoses is a common finding
- Mucosal hemorrhages is a common finding
- Uncontrolled bleeding from venipuncture locals is a common finding
Eyes
- Conjunctival injection is a common finding
Nose
- Epistaxis may be present.
- Nasal discharge may be present.[1]
Throat
- Mucosal hyperemia of the oral cavity is a common finding.
- Bleeding gums is a common finding.
Abdomen
- Abdominal tenderness may be present.
Extremities
- Edema may be present.
Neurologic
- Obtundation may be present.[5][6][7]
References
- ↑ 1.0 1.1 1.2 Feldmann, Heinz; Geisbert, Thomas W (2011). "Ebola haemorrhagic fever". The Lancet. 377 (9768): 849–862. doi:10.1016/S0140-6736(10)60667-8. ISSN 0140-6736.
- ↑ Formenty, Pierre; Hatz, Christophe; Le Guenno, Bernard; Stoll, Agnés; Rogenmoser, Philipp; Widmer, Andreas (1999). "Human Infection Due to Ebola Virus, Subtype Côte d'Ivoire: Clinical and Biologic Presentation". The Journal of Infectious Diseases. 179 (s1): S48–S53. doi:10.1086/514285. ISSN 0022-1899.
- ↑ Gradon J (2000). "An outbreak of Ebola virus: lessons for everyday activities in the intensive care unit". Crit Care Med. 28 (1): 284–5. PMID 10667555.
- ↑ Borchert, Matthias; Mutyaba, Imaam; Van Kerkhove, Maria D; Lutwama, Julius; Luwaga, Henry; Bisoborwa, Geoffrey; Turyagaruka, John; Pirard, Patricia; Ndayimirije, Nestor; Roddy, Paul; Van der Stuyft, Patrick (2011). "Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned". BMC Infectious Diseases. 11 (1): 357. doi:10.1186/1471-2334-11-357. ISSN 1471-2334.
- ↑ Ndambi R, Akamituna P, Bonnet MJ, Tukadila AM, Muyembe-Tamfum JJ, Colebunders R (1999). "Epidemiologic and clinical aspects of the Ebola virus epidemic in Mosango, Democratic Republic of the Congo, 1995". J Infect Dis. 179 Suppl 1: S8–10. doi:10.1086/514297. PMID 9988156.
- ↑ Bwaka MA, Bonnet MJ, Calain P, Colebunders R, De Roo A, Guimard Y; et al. (1999). "Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: clinical observations in 103 patients". J Infect Dis. 179 Suppl 1: S1–7. doi:10.1086/514308. PMID 9988155.
- ↑ Feldmann H, Geisbert TW (2011). "Ebola haemorrhagic fever". Lancet. 377 (9768): 849–62. doi:10.1016/S0140-6736(10)60667-8. PMC 3406178. PMID 21084112.