Whipple's disease physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Bhagyashree Deshmankar M.B.B.S.[2]; Sadaf Sharfaei M.D.[3]
Overview
Patients with Whipple's disease usually appear weak. Physical examination of patients with Whipple's disease is usually remarkable for weight loss and joint pain. Further physical findings depend on the systems involved in the disease.
Physical Examination
- Physical examination of patients with Whipple's disease is usually remarkable for generalized weakness secondary to weight loss.
- The presence of eye findings namely oculomasticatory, or oculofacialskeletal, myorhythmia are pathognomic.
Appearance of the Patient
- Patients with Whipple's disease usually appear tired and weak.
Vital Signs
- Low-grade intermittent fever
Skin
- Pallor
- Hyperpigmentation: more frequent in sun exposed areas.[1]
- Skin nodules
HEENT
- Nystagmus
- Abnormal extra-ocular movements
- Oculomasticatory (pathognomic)
- Oculofacialskeletal (pathognomic)
- Myorhythmia (pathognomic)
Neck
- Lymphadenopathy (common in peripheral lymph nodes)
Lungs
- In patients who develop pleural effusion, may have:
- Asymmetrical chest expansion
- Lungs are hyporesonant
- Distant breath sounds
- Reduced tactile fremitus
Heart
- In patients with cardiac valve involvement, may have:
Abdomen
Neuromuscular
- May be asymptomatic
- Altered level of consciousness
- Seizure
- Myoclonus
- Ataxia
Extremities
- Joint deformity (extremely rare)
References
- ↑ Dutly F, Altwegg M (2001). "Whipple's disease and "Tropheryma whippelii"". Clin Microbiol Rev. 14 (3): 561–83. doi:10.1128/CMR.14.3.561-583.2001. PMC 88990. PMID 11432814.