Cytomegalovirus infection physical examination

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

Physical Examination

General Appearance of the patient

The appearance of the patient depends on the stage of the disease. The patient may look very healthy or be ill-looking and cachectic.

Vitals

Temperature

• Fever can be present.

Pulse

• Tachycardia can be present.

Blood pressure

• Hypotension can be present.

Respiratory rate

• Tachypnea can be seen during fever and respiratory tract infections

Skin

• Folliculitis can be present.
• Seborrheic dermatitis can be present.
• Psoriasis can be present.
• Skin lesions can be present in some cases.

Eyes

• On fundus examination the following findings can be demonstrated:
  • Fluffy yellow-white retinal lesions, with or without intraretinal hemorrhage.
  • Inflammation of the vitreous can be demonstrated in patients with severe immunosuppression.
  • Blood vessels appear sheathed.
  • If left untreated, retinitis is a rapidly progressive condition and on fundus examination it demonstrates a characteristic brushfire pattern, with a granular, white leading edge advancing before an atrophic gliotic scar.

Head

• Tenderness of sinuses may be elicited.

Nose

• Inflammation of the nasal turbinates may be present.

Ears

• Unilateral or bilateral deafness may be present.
• Discharge from the ears may be found.

Throat

• Peridontal disease may be present.
• Oral herpes simplex lesions may be found.
• Oral thrush may be found.

Lungs

• Crackles and rhonchi may be found.
• Dullness to percussion can be present.
• Increased tactile fremitus can be present.

Cardiovascular system

• A heart murmur can be found.

Abdomen

• Abdominal tenderness can be found.
• Hepatomegaly may be detected.
• Splenomegaly may be detected.

Genitourinary

• Vaginal or urethral discharge can be present.

Extremities

• Muscle weakness may be present.
• Joint swelling may be present.

Central Nervous System

• Focal neurological deficits may be found.

• Behavioral changes may be observed.
• Gait disturbances may be present.