Q fever physical examination: Difference between revisions
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__NOTOC__ | |||
{{Q fever}} | {{Q fever}} | ||
{{CMG}};{{AE}}{{AY}} | |||
==Overview== | ==Overview== | ||
Patients with Q fever usually appear ill. Physical examination of patients with Q fever usually shows [[fever]], [[pneumonia]], and [[hepatomegaly]]. | |||
==Physical examination== | |||
Examination of a patient with Q fever might reveal the following signs: | |||
===Vital signs=== | |||
*[[Fever]]: [[Fever|High grade fevers]] that are usually accompanied by [[chills]] and [[sweats]]<ref name="pmid88923">{{cite journal |vauthors=Ishikawa H, Maeda H, Takamatsu H, Saito Y |title=Systemic hyalinosis (juvenile hyaline fibromatosis). Ultrastructure of the hyaline with particular reference to the cross-banded structure |journal=Arch. Dermatol. Res. |volume=265 |issue=2 |pages=195–206 |year=1979 |pmid=88923 |doi= |url=}}</ref><ref name="pmid17423643">{{cite journal |vauthors=Marrie TJ |title=Q fever - a review |journal=Can. Vet. J. |volume=31 |issue=8 |pages=555–63 |year=1990 |pmid=17423643 |pmc=1480833 |doi= |url=}}</ref> | |||
*[[Tachycardia]] | |||
*[[Tachypnea]] | |||
===General=== | |||
*Patient looks ill | |||
===Skin=== | |||
*[[Maculopapular]] or punctate [[rash]] | |||
*[[Erythema nodosum]] | |||
*[[Spider nevi]] if [[Hepatic failure|hepatic decompensation]] is present | |||
===HEENT=== | |||
*[[Jaundice]] | |||
*[[Neck veins|Congested neck veins]] if [[endocarditis]] or [[myocarditis]] is complicated by [[heart failure]]<ref name="pmid6622891">{{cite journal |vauthors=Derrick EH |title="Q" fever, a new fever entity: clinical features, diagnosis and laboratory investigation |journal=Rev. Infect. Dis. |volume=5 |issue=4 |pages=790–800 |year=1983 |pmid=6622891 |doi= |url=}}</ref> | |||
===Lungs=== | |||
*Minimal auscultatory findings in most cases | |||
*[[Crackles]] especially in the lower lung fields | |||
*Decreased breath sounds if [[pleural effusion]] is present | |||
===Abdomen=== | |||
*[[Hepatomegaly]] | |||
*[[Ascites]] if [[chronic hepatitis]] ensues | |||
===Cardiovascular=== | |||
*[[S3]] due to [[hyperdynamic circulation]] | |||
*New onset [[murmur]] if [[endocarditis]] is present | |||
*[[Pericardial rub]] and distant heart sounds if [[pericarditis]] and [[pericardial effusion]] are present | |||
===Neurological examination=== | |||
*[[Neck rigidity]] and positive Brudsiniski and Kuring signs | |||
*Signs of increased [[intracranial pressure]] ([[vomiting]], [[convulsions]], [[Papilledema|papilledema,]] etc) | |||
===Extremities=== | |||
*[[Tenderness]] on palpation of the affected joints and bones | |||
*[[Edema|Lower limb edema]] in presence of [[heart failure]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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Latest revision as of 23:56, 29 July 2020
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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
Patients with Q fever usually appear ill. Physical examination of patients with Q fever usually shows fever, pneumonia, and hepatomegaly.
Physical examination
Examination of a patient with Q fever might reveal the following signs:
Vital signs
- Fever: High grade fevers that are usually accompanied by chills and sweats[1][2]
- Tachycardia
- Tachypnea
General
- Patient looks ill
Skin
- Maculopapular or punctate rash
- Erythema nodosum
- Spider nevi if hepatic decompensation is present
HEENT
- Jaundice
- Congested neck veins if endocarditis or myocarditis is complicated by heart failure[3]
Lungs
- Minimal auscultatory findings in most cases
- Crackles especially in the lower lung fields
- Decreased breath sounds if pleural effusion is present
Abdomen
- Hepatomegaly
- Ascites if chronic hepatitis ensues
Cardiovascular
- S3 due to hyperdynamic circulation
- New onset murmur if endocarditis is present
- Pericardial rub and distant heart sounds if pericarditis and pericardial effusion are present
Neurological examination
- Neck rigidity and positive Brudsiniski and Kuring signs
- Signs of increased intracranial pressure (vomiting, convulsions, papilledema, etc)
Extremities
- Tenderness on palpation of the affected joints and bones
- Lower limb edema in presence of heart failure
References
- ↑ Ishikawa H, Maeda H, Takamatsu H, Saito Y (1979). "Systemic hyalinosis (juvenile hyaline fibromatosis). Ultrastructure of the hyaline with particular reference to the cross-banded structure". Arch. Dermatol. Res. 265 (2): 195–206. PMID 88923.
- ↑ Marrie TJ (1990). "Q fever - a review". Can. Vet. J. 31 (8): 555–63. PMC 1480833. PMID 17423643.
- ↑ Derrick EH (1983). ""Q" fever, a new fever entity: clinical features, diagnosis and laboratory investigation". Rev. Infect. Dis. 5 (4): 790–800. PMID 6622891.