Q fever physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Physical examination:

Vital signs:

  • Fever: High grade fevers that is usually accompanied by chills and night sweats
  • 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

Lungs:

  • Minimal auscultatory findings in most of the cases
  • Crackles especially in the lower lung fields
  • Decreased breath sounds if pleural effusion is present

Abdomen:

  • Hepatomegaly
  • Ascites if chronic hepatitis ensues

Heart:

  • S3 due to hyperdynamic circulation
  • New onset murmer if endocarditis is present
  • Pericardial rub and distant heart sounds if pericarditis and pericardial effusion is 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


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