Hamman-Rich syndrome physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

Overview

Patients with acute interstitial pneumonitis usually appear ill. Physical examination shows tachypnea, tachycardia, crackles, wheezing and signs of hypoxemia.

Physical Examination

• Physical examination of patients with acute interstitial pneumonitis will show tachypnea, tachycardia, cyanosis, crackles, and wheezes on auscultation.

Appearance of the Patient

• Patients with acute interstitial pneumonitis usually appear ill.

Vital Signs

• Fever
• Tachycardia
• Tachypnea

Skin

• Cyanosis because of hypoxemia.

HEENT

• Flared nares

Neck

• Neck examination of patients with acute interstitial pneumonitis is usually normal.

Heart

• Tachycardia
• Examine heart for findings of congestive heart failure to exclude the diagnosis.

Lungs

• Diffuse  crackles upon auscultation of the lungs bilaterally
• Wheezing may be present
• Prolonged expiration
• Persistent scattered rhonchi

Extremities

• Clubbing is not usually present in acute interstitial pneumonitis. Presence of clubbing indicates exacerbation of preexisting fibrotic lung disease.
• Cyanosis due to hypoxemia