Lassa fever physical examination: Difference between revisions

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Latest revision as of 18:09, 18 September 2017

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

Synonyms and keywords: Lassa hemorrhagic fever; LHF

Overview

Persistent, high-grade fever is the most common sign on physical examination. Other common signs on physical examination include tachycardia, tachypnea, conjunctival injection, abdominal/chest tenderness, pharyngitis with tonsillar exudates, and hepatosplenomegaly.

Physical Examination

General Appearance

In distress
Sick-looking

Vital Signs

Persistent, high-grade fever
Tachycardia or relative bradycardia
Hypotension
Tachypnea

Skin

Uncontrolled bleeding from venipuncture sites
Jaundice

HEENT and Neck

Conjunctival injection
Conjunctival hemorrhage
Nasal flaring
Epistaxis
Nasal discharge
Hearing impairment (abnormal Renne and Weber tests)
Mucosal hyperemia of the oral cavity
Pharyngitis with exudation
Cervical lymphadenopathy

Thoracic

Paradoxical breathing
Chest tenderness

Abdomen

Abdominal tenderness
Abdominal distention
Tender hepatomegaly
Splenomegaly
Bowel sounds may be hyperactive (bleeding) or hypoactive (ileus)

Extremities

Extremity edema

Neurologic

References

Template:WikiDoc Sources

@@ Line 2: / Line 2: @@
 {{Lassa fever}}
 {{CMG}}; {{AE}} {{Ammu}}
+{{SK}} Lassa hemorrhagic fever; LHF
 ==Overview==
-Lassa fever is commonly associated with [[fever]] on physical examination at admission. At advanced stages of the disease, physical examination findings are more pertinent and often include unstable vital signs, such as [[tachycardia]] or relative [[bradycardia]], [[hypotension]], and [[tachypnea]]. Physical examination may also be remarkable for [[abdominal tenderness]] and distension and neurological impairment.
+Persistent, high-grade fever is the most common sign on physical examination. Other common signs on physical examination include tachycardia, tachypnea, conjunctival injection, abdominal/chest tenderness, pharyngitis with tonsillar exudates, and hepatosplenomegaly.
 ==Physical Examination==
-===Appearance of the Patient===
+===General Appearance===
-The general appearance of the patient depends on the severity of the disease. Typically, patients demonstrate [[prostration]], may be [[nauseated]] and [[vomiting]], and less commonly very ill looking<ref name="pmid26022703">{{cite journal| author=Kyei NN, Abilba MM, Kwawu FK, Agbenohevi PG, Bonney JH, Agbemaple TK et al.| title=Imported Lassa fever: a report of 2 cases in Ghana. | journal=BMC Infect Dis | year= 2015 | volume= 15 | issue= 1 | pages= 217 | pmid=26022703 | doi=10.1186/s12879-015-0956-2 | pmc=PMC4448534 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26022703  }} </ref>.
+*In distress
-===Vitals===
+*Sick-looking
-====Temperature====
-* High-grade [[fever]] is often present in more than 80% of patients. Fever is the most common presenting sign.
-====Pulse====
-*[[Tachycardia]]
-* Relative [[bradycardia]]
-====Blood Pressure====
-* [[Hypotension]] (SBP<90 mmHg and/or DBP<60 mmHg)
-* [[Postural hypotension]] is common in dehydrated patients with inadequate volume repletion
-====Respiratory Rate====
+===Vital Signs===
-*[[Signs]] of [[shortness of breath|respiratory difficulty]] may be present, such as:
+* Persistent, high-grade [[fever]]
-:* [[Intercostal]] retractions
+*[[Tachycardia]] or relative [[bradycardia]]
-:* Paradoxical [[breathing]]
+*[[Hypotension]]
-:* [[Nasal]] flare
+*Tachypnea
-*[[Tachypnea]] often precedes death during final hours of infection.
 ===Skin===
-:* Uncontrolled [[bleeding]] from [[venipuncture]] can occur if there is platelet dysfunction.
+*Uncontrolled [[bleeding]] from [[venipuncture]] sites
+*Jaundice
-===Eyes===
+===HEENT and Neck===
-* [[Conjunctival hemorrhage]] is a the most common sign of abnormal clotting
+* [[Conjunctival injection]]
-* [[Conjunctivitis]]
+* [[Conjunctival hemorrhage]]
+* [[Nasal flaring]]
+* [[Epistaxis]]
+* [[Nasal discharge]]
+* [[Hearing impairment]] (abnormal Renne and Weber tests)
+* [[Mucosal]] [[hyperemia]] of the [[oral cavity]]
+* [[Pharyngitis]] with exudation
+* [[Cervical lymphadenopathy]]
-===Nose===
+===Thoracic===
-* [[Epistaxis]] may be present.
+*Paradoxical breathing
-* [[Nasal discharge]] may be present.
+*Chest tenderness
-===Throat===
-* [[Mucosal]] [[hyperemia]] of the [[oral cavity]] is a common finding.
 ===Abdomen===
-* [[Abdominal tenderness]] may suggest [[pancreatitis]], [[intestinal swelling]], or [[mesenteric lymphadenopathy]]
+* [[Abdominal tenderness]]
-* [[Abdominal distention]] may suggest [[paralytic ileus]]
+* [[Abdominal distention]]
-*Tender hepatomegaly
+* Tender [[hepatomegaly]]
-*Splenomegaly
+* [[Splenomegaly]]
-* Bowel sounds are usually present.
+* Bowel sounds may be hyperactive (bleeding) or hypoactive (ileus)
 ===Extremities===
-* [[Edema]] may be present.
+* Extremity [[edema]]
 ===Neurologic===
-* [[Obtundation]] may be present.
+* [[Obtundation]]
-*[[Stupor]]
+* [[Stupor]]
-*[[Coma]]
+* [[Coma]]
+* [[Tremor]]
 ==References==
 {{Reflist|2}}
@@ Line 63: / Line 62: @@
 [[Category:Tropical disease]]
 [[Category:Biological weapons]]
-[[Category:Infectious disease]]
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 {{WikiDoc Sources}}