Sudden infant death syndrome physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

Overview

Patients with sudden infant death syndrome (SIDS) usually appear normal. In nearly 50% of the patients the physical examination is totally normal. WHile doing a physical examination on sudden infant death syndrome (SIDS) patients physicians must take care to examine any signs of obstruction of the external airways, head entrapment, or any other environmental risk factors.

Physical Examination

Physical examination in 50% of the patients with sudden infant death syndrome (SIDS) is usually completely normal.

Appearance of the Patient

• Patients with sudden infant death syndrome (SIDS) usually appear normal.

Vital Signs

• High-grade or low-grade fever may be present in 25% of the patients with SIDS
• Infection may be present in 25% of the patients with SIDS
• Look for any signs of choking or gasping of the infant

Skin

Apparent life-threatening events (ALTEs) are usally episodes of apnea that are associated with skin colour changes, which include the following:

• Cyanosis in 50-60% of the patients may be present.
• Pallor
• Erythema

HEENT

• Feeding difficulties may be present in some patients
• Evidence of trauma

Neck

• Neck examination of patients with sudden infant death syndrome (SIDS) is usually normal.

• Check for any signs of obstruction

Lungs

• Breathing difficulties in 50% of the patients may be present
• Any signs of respiratory infections should be evaluated
• Physicians must take care to examine any signs of obstruction of the external airway

Heart

• Cardiovascular examination of patients with SIDS may or may not be present with the following and should be evaluated:
  • Any signs of valvular disease
  • Arrhythmias
  • Cardiomyopathy signs

Abdomen

• Abdominal examination of patients with sudden infant death syndrome (SIDS) is usually normal.

Back

• Back examination of patients with sudden infant death syndrome (SIDS) is usually normal.

Genitourinary

• Genitourinary examination of patients with sudden infant death syndrome (SIDS) is usually normal.

Neuromuscular

• Abnormal limb movements in 35% of the patients in SIDS may be noted
• Should look for any changes in muscle tone
• Seizures

Extremities

• Cyanosis may be present in some infants with SIDS
• Muscle tone either increased or decreased in some infants with SIDS